Provider Demographics
NPI:1972887859
Name:BROWN, TIMOTHY BRAD (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:BRAD
Last Name:BROWN
Suffix:
Gender:M
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:PO BOX 208
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36461-0208
Mailing Address - Country:US
Mailing Address - Phone:251-743-2575
Mailing Address - Fax:251-575-3887
Practice Address - Street 1:360 S ALABAMA AVE
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:AL
Practice Address - Zip Code:36460-1806
Practice Address - Country:US
Practice Address - Phone:251-743-2575
Practice Address - Fax:251-575-3887
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL15521183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL15521OtherALABAMA BOARD OF PHARMACY