Provider Demographics
NPI:1619067683
Name:BROWER DRUG CO
Entity Type:Organization
Organization Name:BROWER DRUG CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RPH OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:BROWER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:641-713-4381
Mailing Address - Street 1:PO BOX 309
Mailing Address - Street 2:140 W 4TH ST SUITE III
Mailing Address - City:ST ANSGAR
Mailing Address - State:IA
Mailing Address - Zip Code:50472
Mailing Address - Country:US
Mailing Address - Phone:641-713-4381
Mailing Address - Fax:641-713-2386
Practice Address - Street 1:140 W 4TH ST
Practice Address - Street 2:SUITE III
Practice Address - City:ST ANSGAR
Practice Address - State:IA
Practice Address - Zip Code:50472
Practice Address - Country:US
Practice Address - Phone:641-713-4381
Practice Address - Fax:641-713-2386
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA13613183500000X
IA177333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Not Answered333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1601942OtherNABP
IA0080366Medicaid
IA0080366Medicaid