Provider Demographics
NPI:1497841654
Name:BROWN DRUG COMPANY INC
Entity Type:Organization
Organization Name:BROWN DRUG COMPANY INC
Other - Org Name:MED CENTER PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:L
Authorized Official - Last Name:GIBBS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-872-3255
Mailing Address - Street 1:101 SAMUEL O MOSELEY DR
Mailing Address - Street 2:
Mailing Address - City:SELMA
Mailing Address - State:AL
Mailing Address - Zip Code:36701-6730
Mailing Address - Country:US
Mailing Address - Phone:334-874-9495
Mailing Address - Fax:334-874-9929
Practice Address - Street 1:101 SAMUEL O MOSELEY DR
Practice Address - Street 2:
Practice Address - City:SELMA
Practice Address - State:AL
Practice Address - Zip Code:36701-6730
Practice Address - Country:US
Practice Address - Phone:334-874-9495
Practice Address - Fax:334-874-9929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2023-03-23
Deactivation Date:2006-10-06
Deactivation Code:
Reactivation Date:2008-03-21
Provider Licenses
StateLicense IDTaxonomies
333600000X
AL1118783336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1994849OtherPK
AL100003218Medicaid
1994849OtherPK