MEDICARE: PAUL PIERRE 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
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1891266003
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL PIERRE BROWN

Provider Business Mailing Address
First Line	:	4986 WETLAND XING APT 2302
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29418-7006
Country	:	US
Telephone Number	:	843-304-1599
Fax Number	:

Provider Business Practice Location Address
First Line	:	4986 WETLAND XING APT 2302
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29418-7006
Country	:	US
Telephone Number	:	843-304-1599
Fax Number	:

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

Provider Enumeration Date	:	12/16/2018
Last Update Date	:	12/16/2018

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