MEDICARE: MR. ROBERT MICHAEL BROWN SR. RPH

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	4682	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3401964	OTHER		NABP

General Provider Information

NPI Number	:	1598790412
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROBERT MICHAEL BROWN SR. RPH

Provider Business Mailing Address
First Line	:	110 CYPRESS BAY
Second Line	:	EDGEWATER ROAD
City	:	WASHINGTON
State	:	NC
Zip	:	27889
Country	:	US
Telephone Number	:	252-946-2373
Fax Number	:

Provider Business Practice Location Address
First Line	:	329 N FAIRVIEW ROAD
Second Line	:
City	:	ROCKY MOUNT
State	:	NC
Zip	:	27801
Country	:	US
Telephone Number	:	252-442-8159
Fax Number	:	252-442-0332

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

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	07/08/2007

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