Provider Demographics
NPI:1043532070
Name:BROWN, HEATHER (PHARM D)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:
Other - Last Name:HENDRICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D
Mailing Address - Street 1:3395 DUNBAR LN
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29707-6900
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1510 SARDIS RD N
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28270-1408
Practice Address - Country:US
Practice Address - Phone:704-704-5861
Practice Address - Fax:704-708-6067
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-17
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC19950183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist