Individual
GARY IVAN BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
292 MAIN STREET, GILBERT, WV 25621
(304) 664-9800
(304) 664-2358
Mailing address
292 MAIN STREET, PO BOX 338, GILBERT, WV 25621-0338
(304) 664-9800
(304) 664-2358
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
0202007074
VA
183500000X
Pharmacist
Primary
RP0004185
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0202007074
STATE OF VA BOARD OF PHARMACY LICENSE
VA
01
—
RP0004185
STATE OF WV BOARD OF PHARMACY LICENSE
WV
Enumeration date
09/02/2009
Last updated
09/02/2009
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