Provider Demographics
NPI:1871194480
Name:BROWN, TAMMY LEE (RPH)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:LEE
Last Name:BROWN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1871 AMHERST ST
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-2801
Mailing Address - Country:US
Mailing Address - Phone:540-662-7753
Mailing Address - Fax:
Practice Address - Street 1:201 MARANTO MANOR DR
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22602-4807
Practice Address - Country:US
Practice Address - Phone:540-868-5109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-02
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0004893183500000X
VA0202007770183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist