MEDICARE: ANDREW E BROWN PHARM D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	PCT.0012002	CT

General Provider Information

NPI Number	:	1114369048
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW E BROWN PHARM D.

Provider Business Mailing Address
First Line	:	3 HACKETT CIR W
Second Line	:	UNIT 4A
City	:	STAMFORD
State	:	CT
Zip	:	06906-1913
Country	:	US
Telephone Number	:	774-571-0173
Fax Number	:

Provider Business Practice Location Address
First Line	:	3 HACKETT CIR W
Second Line	:	UNIT 4A
City	:	STAMFORD
State	:	CT
Zip	:	06906-1913
Country	:	US
Telephone Number	:	774-571-0173
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2013
Last Update Date	:	07/19/2013

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