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Organization
BROWN DRUG CO INC
Active
Organization
BROWN DRUG CO INC
Active
Other names
DALLAS AVENUE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY L GIBBS (PRESIDENT)
(334) 872-3255
Entity
Organization
Contact information
Practice address
1402 W DALLAS AVE, SELMA, AL 36701-7017
(334) 872-3255
(334) 874-9453
Mailing address
1402 W DALLAS AVE, SELMA, AL 36701-7017
(334) 872-3255
(334) 874-9453
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
103015
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0123430
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
100002422
—
AL
Enumeration date
08/01/2006
Last updated
03/23/2023
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