Provider Demographics
NPI:1134252547
Name:BROWN, GRANT HAROLD (PHARMD)
Entity type:Individual
Prefix:DR
First Name:GRANT
Middle Name:HAROLD
Last Name:BROWN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1410 W GANSON ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49202-4063
Mailing Address - Country:US
Mailing Address - Phone:517-789-7971
Mailing Address - Fax:517-789-0115
Practice Address - Street 1:2136 ROBINSON RD
Practice Address - Street 2:SUITE 2
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49203-3557
Practice Address - Country:US
Practice Address - Phone:517-750-2180
Practice Address - Fax:517-750-2181
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302024309183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist