Provider Demographics
NPI:1023318656
Name:BROWN, ROBERT BROWER (RPH)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:BROWER
Last Name:BROWN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 DEERFIELD DR
Mailing Address - Street 2:
Mailing Address - City:MILAN
Mailing Address - State:TN
Mailing Address - Zip Code:38358-5121
Mailing Address - Country:US
Mailing Address - Phone:731-499-0288
Mailing Address - Fax:
Practice Address - Street 1:35 WEST UNIVERSITY AVE
Practice Address - Street 2:KROGER PHARMACY
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305
Practice Address - Country:US
Practice Address - Phone:731-661-0327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-29
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5463183500000X
LA13512183500000X
MS6972183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist