Provider Demographics
NPI:1619056702
Name:BROWN, WILLIAM SAMMY (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:SAMMY
Last Name:BROWN
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 217
Mailing Address - Street 2:5325 ATLANTA HIGHWAY
Mailing Address - City:FLOWERY BRANCH
Mailing Address - State:GA
Mailing Address - Zip Code:30542-0004
Mailing Address - Country:US
Mailing Address - Phone:770-967-3324
Mailing Address - Fax:770-967-0830
Practice Address - Street 1:5325 ATLANTA HIGHWAY
Practice Address - Street 2:
Practice Address - City:FLOWERY BRANCH
Practice Address - State:GA
Practice Address - Zip Code:30542-0004
Practice Address - Country:US
Practice Address - Phone:770-967-3324
Practice Address - Fax:770-967-0830
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH010832183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist