Provider Demographics
NPI:1780272393
Name:BROWN, HENRY CHAPMAN III
Entity type:Individual
Prefix:
First Name:HENRY
Middle Name:CHAPMAN
Last Name:BROWN
Suffix:III
Gender:M
Credentials:
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 456
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:VA
Mailing Address - Zip Code:24557-0456
Mailing Address - Country:US
Mailing Address - Phone:434-656-1251
Mailing Address - Fax:434-656-6003
Practice Address - Street 1:108 VADEN DR
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:VA
Practice Address - Zip Code:24557-4160
Practice Address - Country:US
Practice Address - Phone:143-465-6125
Practice Address - Fax:434-656-6003
Is Sole Proprietor?:No
Enumeration Date:2021-01-08
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202006994183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist