Provider Demographics
NPI:1427269612
Name:BROWN, WILLIAM L (PHARMACIST)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:L
Last Name:BROWN
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2554 GINGER WREN RD
Mailing Address - Street 2:
Mailing Address - City:PEPPER PIKE
Mailing Address - State:OH
Mailing Address - Zip Code:44124-4564
Mailing Address - Country:US
Mailing Address - Phone:216-360-0094
Mailing Address - Fax:216-360-0024
Practice Address - Street 1:2816 E 116TH ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44120-2111
Practice Address - Country:US
Practice Address - Phone:216-957-4050
Practice Address - Fax:216-957-4051
Is Sole Proprietor?:No
Enumeration Date:2007-05-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-3-07936183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist