Provider Demographics
NPI:1942966536
Name:BROWN'S PROFESSIONAL SERVICES, INC.
Entity Type:Organization
Organization Name:BROWN'S PROFESSIONAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GRANT
Authorized Official - Middle Name:HAROLD
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:517-789-8980
Mailing Address - Street 1:1410 W GANSON ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49202-4063
Mailing Address - Country:US
Mailing Address - Phone:517-789-8980
Mailing Address - Fax:
Practice Address - Street 1:2136 ROBINSON RD STE 2
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49203-3558
Practice Address - Country:US
Practice Address - Phone:517-750-2180
Practice Address - Fax:517-750-2181
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BROWN'S PROFESSIONAL SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-11-09
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1962565895Medicaid