Provider Demographics
NPI:1376326751
Name:BROWNS PRESTIGE LCC
Entity Type:Organization
Organization Name:BROWNS PRESTIGE LCC
Other - Org Name:BROWN'S ADVANCED CARE LTC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER/ PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GRANT
Authorized Official - Middle Name:H
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:517-789-8980
Mailing Address - Street 1:1410 W GANSON ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49202-4063
Mailing Address - Country:US
Mailing Address - Phone:517-789-8980
Mailing Address - Fax:
Practice Address - Street 1:2136 ROBINSON RD STE 6
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49203-3558
Practice Address - Country:US
Practice Address - Phone:517-750-2183
Practice Address - Fax:517-750-2184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-17
Last Update Date:2023-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy