MEDICARE: BROWN DRUGS, INC.

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	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2013750	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497822076
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BROWN DRUGS, INC.

Provider Business Mailing Address
First Line	:	PO BOX 128
Second Line	:
City	:	LUMBER CITY
State	:	GA
Zip	:	31549
Country	:	US
Telephone Number	:	912-363-4979
Fax Number	:	912-363-8453

Provider Business Practice Location Address
First Line	:	3316 E GOLDEN ISLES PARKWAY
Second Line	:
City	:	LUMBER CITY
State	:	GA
Zip	:	31549
Country	:	US
Telephone Number	:	912-363-4979
Fax Number	:	912-363-8453

Authorized Official
Title or Position	:	OWNER / PHARMACIST
Name	:	DR. JORDAN KOLBY BROWN
Credential	:	PHARM.D.
Telephone Number	:	912-363-4979

Provider Enumeration Date	:	11/29/2006
Last Update Date	:	10/19/2018

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