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General NPI Number Information
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NPI Number | 1871119560
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Entity Type | Individual
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Provider Name | GLEN DEVON BROWN PHARMD
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Gender | Male
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Dates
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Enumeration Date | 06/18/2020
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Last Update Date | 06/18/2020
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Provider Practice Location Address
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Address Line | 9600 N METRO PKWY W
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City | PHOENIX
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State | AZ
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Zip | 85051-1402
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Country | US
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Telephone | 480-337-0256
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Fax | 480-337-0257
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Provider Business Mailing Address
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Address Line | 6234 W BEHREND DR APT 2134
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City | GLENDALE
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State | AZ
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Zip | 85308-6916
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Country | US
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Telephone | 574-323-4727
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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 | S024613
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License Number State | AZ
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