Provider Demographics
NPI:1255735528
Name:BROWN, JOHN IRWIN (RPH)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:IRWIN
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 1:401 CHEYENNE
Mailing Address - Street 2:PO BOX 159
Mailing Address - City:SATANTA
Mailing Address - State:KS
Mailing Address - Zip Code:67870-8748
Mailing Address - Country:US
Mailing Address - Phone:620-649-2450
Mailing Address - Fax:620-649-2959
Practice Address - Street 1:401 CHEYENNE
Practice Address - Street 2:
Practice Address - City:SATANTA
Practice Address - State:KS
Practice Address - Zip Code:67870-8748
Practice Address - Country:US
Practice Address - Phone:620-649-2450
Practice Address - Fax:620-649-2959
Is Sole Proprietor?:No
Enumeration Date:2014-10-15
Last Update Date:2014-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-150401835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric