Provider Demographics
NPI:1497358543
Name:BROWN, CHARITY (RPH)
Entity Type:Individual
Prefix:
First Name:CHARITY
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 E SEYMOUR ST
Mailing Address - Street 2:
Mailing Address - City:KENTLAND
Mailing Address - State:IN
Mailing Address - Zip Code:47951-1240
Mailing Address - Country:US
Mailing Address - Phone:219-474-6787
Mailing Address - Fax:219-474-6808
Practice Address - Street 1:512 E SEYMOUR ST
Practice Address - Street 2:
Practice Address - City:KENTLAND
Practice Address - State:IN
Practice Address - Zip Code:47951-1240
Practice Address - Country:US
Practice Address - Phone:219-474-6787
Practice Address - Fax:219-474-6808
Is Sole Proprietor?:No
Enumeration Date:2020-11-20
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26019030A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist