Provider Demographics
NPI:1407160708
Name:BROWN, MARC B (RPH)
Entity Type:Individual
Prefix:
First Name:MARC
Middle Name:B
Last Name:BROWN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 LANTERN LN
Mailing Address - Street 2:
Mailing Address - City:WRENTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02093-1740
Mailing Address - Country:US
Mailing Address - Phone:508-337-8800
Mailing Address - Fax:508-337-6193
Practice Address - Street 1:243 CHAUNCY ST
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:MA
Practice Address - Zip Code:02048-1247
Practice Address - Country:US
Practice Address - Phone:508-337-8800
Practice Address - Fax:508-337-6193
Is Sole Proprietor?:No
Enumeration Date:2010-07-29
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH23597183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist