Provider Demographics
NPI:1275766818
Name:BROWN, THORA ANN (PHARMD, CPP)
Entity Type:Individual
Prefix:DR
First Name:THORA
Middle Name:ANN
Last Name:BROWN
Suffix:
Gender:F
Credentials:PHARMD, CPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2817 REILLY ST
Mailing Address - Street 2:
Mailing Address - City:FORT BRAGG
Mailing Address - State:NC
Mailing Address - Zip Code:28310-1308
Mailing Address - Country:US
Mailing Address - Phone:910-907-6337
Mailing Address - Fax:910-907-8565
Practice Address - Street 1:2817 REILLY ST
Practice Address - Street 2:
Practice Address - City:FORT BRAGG
Practice Address - State:NC
Practice Address - Zip Code:28310-7324
Practice Address - Country:US
Practice Address - Phone:910-907-6337
Practice Address - Fax:910-907-8565
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-31
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH0276561835P0018X
NC0070-003271835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist