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General NPI Number Information
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NPI Number | 1770174476
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Entity Type | Individual
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Provider Name | WAYLON BROWN
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Gender | Male
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Dates
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Enumeration Date | 01/27/2021
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Last Update Date | 01/27/2021
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Provider Practice Location Address
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Address Line | 723 LOMBARD RD
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City | RED LION
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State | PA
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Zip | 17356-8396
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Country | US
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Telephone | 717-244-4501
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Fax |
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Provider Business Mailing Address
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Address Line | 710 APPLE TREE LN
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City | MOUNT WOLF
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State | PA
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Zip | 17347-9009
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Country | US
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Telephone | 717-819-2906
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 10558
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 4351
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License Number State | MT
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 445474
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License Number State | PA
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