Provider Demographics
NPI:1235484858
Name:BROWN, BERNARD A (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:A
Last Name:BROWN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2450 SHOPPERS LN
Mailing Address - Street 2:T2527
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19150-1526
Mailing Address - Country:US
Mailing Address - Phone:267-628-3281
Mailing Address - Fax:267-628-3291
Practice Address - Street 1:2450 SHOPPERS LN
Practice Address - Street 2:T2527
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19150-1526
Practice Address - Country:US
Practice Address - Phone:267-628-3281
Practice Address - Fax:267-628-3291
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-19
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP446751183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist