Provider Demographics
NPI:1124891916
Name:BROWN, DENNIS (RPH)
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
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 524
Mailing Address - Street 2:
Mailing Address - City:ARKADELPHIA
Mailing Address - State:AR
Mailing Address - Zip Code:71923-0524
Mailing Address - Country:US
Mailing Address - Phone:877-420-9400
Mailing Address - Fax:877-420-9410
Practice Address - Street 1:521 MAIN ST
Practice Address - Street 2:ARKADELPHIA
Practice Address - City:ARKANSAS
Practice Address - State:AR
Practice Address - Zip Code:71923-6035
Practice Address - Country:US
Practice Address - Phone:877-420-9400
Practice Address - Fax:877-420-9410
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-02
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD14801183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty