Provider Demographics
NPI:1407403447
Name:BROWNSVILLE PHARMACY INC
Entity Type:Organization
Organization Name:BROWNSVILLE PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DESIREE
Authorized Official - Middle Name:CHANTELL
Authorized Official - Last Name:CHRISTNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-785-7095
Mailing Address - Street 1:27 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15417-1787
Mailing Address - Country:US
Mailing Address - Phone:724-785-7095
Mailing Address - Fax:724-785-7098
Practice Address - Street 1:27 MARKET ST
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15417-1787
Practice Address - Country:US
Practice Address - Phone:724-785-7095
Practice Address - Fax:724-785-7098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-23
Last Update Date:2019-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1022512270001Medicaid