Provider Demographics
NPI:1518955582
Name:ANDREW BROWNS DRUG STORE, INC
Entity Type:Organization
Organization Name:ANDREW BROWNS DRUG STORE, INC
Other - Org Name:ANDREW BROWN'S HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:F
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MHA
Authorized Official - Phone:570-343-2442
Mailing Address - Street 1:1502 PITTSTON AVE
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18505-1668
Mailing Address - Country:US
Mailing Address - Phone:570-346-7319
Mailing Address - Fax:570-343-5850
Practice Address - Street 1:1502 PITTSTON AVE
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18505-1668
Practice Address - Country:US
Practice Address - Phone:570-346-7319
Practice Address - Fax:570-343-5850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332BC3200X, 332BX2000X
PA04227321333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Not Answered332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Not Answered333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0005764360002Medicaid
PA0005764360003Medicaid
PA0005764360003Medicaid
PA0210170003Medicare NSC
PA0210170002Medicare NSC