Provider Demographics
NPI:1043310600
Name:BROWN, REBECCA COLE (PHARMD)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:COLE
Last Name:BROWN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1751 N ELM ST
Mailing Address - Street 2:PO BOX 395
Mailing Address - City:COMMERCE
Mailing Address - State:GA
Mailing Address - Zip Code:30529-2316
Mailing Address - Country:US
Mailing Address - Phone:706-335-3111
Mailing Address - Fax:706-335-0984
Practice Address - Street 1:1751 N ELM ST
Practice Address - Street 2:
Practice Address - City:COMMERCE
Practice Address - State:GA
Practice Address - Zip Code:30529-2316
Practice Address - Country:US
Practice Address - Phone:706-335-3111
Practice Address - Fax:706-335-0984
Is Sole Proprietor?:No
Enumeration Date:2006-09-24
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA021613183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist