Provider Demographics
NPI:1851064117
Name:BROWN, SHAWN-TA DE-VAUGHN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SHAWN-TA
Middle Name:DE-VAUGHN
Last Name:BROWN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 MEADOWCROFT DR
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29154-8389
Mailing Address - Country:US
Mailing Address - Phone:803-973-9599
Mailing Address - Fax:
Practice Address - Street 1:3306 W PALMETTO ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-5942
Practice Address - Country:US
Practice Address - Phone:843-317-9365
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-30
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC429451835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist