Provider Demographics
NPI:1407933070
Name:BROWN, TOBY ALLEN (RPH)
Entity Type:Individual
Prefix:MR
First Name:TOBY
Middle Name:ALLEN
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 1:33001 207TH ST
Mailing Address - Street 2:WALNUT RIDGE FARM
Mailing Address - City:EASTON
Mailing Address - State:KS
Mailing Address - Zip Code:66020-7312
Mailing Address - Country:US
Mailing Address - Phone:913-682-4904
Mailing Address - Fax:
Practice Address - Street 1:5000 S 13TH ST
Practice Address - Street 2:
Practice Address - City:LEAVENWORTH
Practice Address - State:KS
Practice Address - Zip Code:66048-5581
Practice Address - Country:US
Practice Address - Phone:913-727-4845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-09218183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist