Provider Demographics
NPI:1952418683
Name:BROWN, SCOTT A (RPH)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:A
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 1:309 CAMBRIDGE POINTE
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25309-8595
Mailing Address - Country:US
Mailing Address - Phone:304-206-7840
Mailing Address - Fax:
Practice Address - Street 1:1097 FLEDDERJOHN RD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25314-4208
Practice Address - Country:US
Practice Address - Phone:304-767-7920
Practice Address - Fax:304-767-7929
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV5622183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist