Organization Name: | BROWN DRUG CO INC DBA DALLAS AVENUE PHARMACY |
NPI Number: | 1023145935 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TIM GIBBS (SUPERVISING PHARMACIST) |
Mailing Address: | 1402 W Dallas Ave Selma |
State: | AL US |
Postal Code: | 367017017 |
Phone Number: | 3348723255 |
Fax Number: | 3348749453 |
NPI Enumeration Date: | 02/27/2007 |
NPI Last Update Date: | 04/29/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 1157910001 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |