Provider Demographics
NPI:1013511419
Name:BROWN, TONYA WHITE
Entity Type:Individual
Prefix:
First Name:TONYA
Middle Name:WHITE
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CVS PHARMACY
Mailing Address - Street 2:240 HWY 31-N
Mailing Address - City:HARTSELLE
Mailing Address - State:AL
Mailing Address - Zip Code:35640
Mailing Address - Country:US
Mailing Address - Phone:256-773-1768
Mailing Address - Fax:
Practice Address - Street 1:240 HWY 31-N
Practice Address - Street 2:STE 11
Practice Address - City:HARTSELLE
Practice Address - State:AL
Practice Address - Zip Code:35640
Practice Address - Country:US
Practice Address - Phone:256-771-1768
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-25
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL13446183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist