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NPI Code Detail

MEDICARE: JACOB JAMES BROWN

MEDICARE: JACOB JAMES BROWN
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
1183500000XPharmacist25494IA

General Provider Information

NPI Number : 1750246997
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACOB JAMES BROWN
Provider Business Mailing Address
First Line : 9510 PRAIRIE CENTER RD
Second Line :
City : MORRISON
State : IL
Zip : 61270-9359
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1410 N 4TH ST
Second Line :
City : CLINTON
State : IA
Zip : 52732-2940
Country : US
Telephone Number : 563-244-5555
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2025
Last Update Date : 12/19/2025

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