MEDICARE: EUGENE FRANKLIN BROWN SR. R.PH.

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	E5698	MS

General Provider Information

NPI Number	:	1750949830
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EUGENE FRANKLIN BROWN SR. R.PH.

Provider Business Mailing Address
First Line	:	584 E MAIN ST STE B3
Second Line	:
City	:	PHILADELPHIA
State	:	MS
Zip	:	39350-2330
Country	:	US
Telephone Number	:	601-656-2272
Fax Number	:	601-650-9040

Provider Business Practice Location Address
First Line	:	584 E MAIN ST STE B3
Second Line	:
City	:	PHILADELPHIA
State	:	MS
Zip	:	39350-2330
Country	:	US
Telephone Number	:	601-656-2272
Fax Number	:	601-650-9040

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

Provider Enumeration Date	:	06/03/2019
Last Update Date	:	06/03/2019

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