Provider Demographics
NPI:1285417766
Name:BROWN, TROY (RPH)
Entity type:Individual
Prefix:
First Name:TROY
Middle Name:
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:PO BOX 427
Mailing Address - Street 2:
Mailing Address - City:HILLMAN
Mailing Address - State:MI
Mailing Address - Zip Code:49746-0427
Mailing Address - Country:US
Mailing Address - Phone:989-354-2197
Mailing Address - Fax:989-354-1952
Practice Address - Street 1:1910 E MILLER RD
Practice Address - Street 2:
Practice Address - City:FAIRVIEW
Practice Address - State:MI
Practice Address - Zip Code:48621-8731
Practice Address - Country:US
Practice Address - Phone:989-848-5644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-17
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302028978183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist