Provider Demographics
NPI:1457324063
Name:BROWN'S PHARMACY INC
Entity Type:Organization
Organization Name:BROWN'S PHARMACY INC
Other - Org Name:BROWN'S PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:SANFORD
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:570-673-4372
Mailing Address - Street 1:47 SULLIVAN ST
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:PA
Mailing Address - Zip Code:17724-1729
Mailing Address - Country:US
Mailing Address - Phone:570-673-4372
Mailing Address - Fax:570-673-7247
Practice Address - Street 1:47 SULLIVAN ST
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:PA
Practice Address - Zip Code:17724-1729
Practice Address - Country:US
Practice Address - Phone:570-673-4372
Practice Address - Fax:570-673-7247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP415334L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA3973624OtherNABP
PA0016641300001Medicaid
PA1324360001Medicare ID - Type UnspecifiedMEDICARE PROVIDER #