Provider Demographics
NPI:1861939316
Name:BROWN, CINDY J
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:J
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4540 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SHALLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28470-4446
Mailing Address - Country:US
Mailing Address - Phone:910-754-2885
Mailing Address - Fax:910-754-2885
Practice Address - Street 1:4540 MAIN ST
Practice Address - Street 2:
Practice Address - City:SHALLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28470-4446
Practice Address - Country:US
Practice Address - Phone:910-754-2885
Practice Address - Fax:910-754-2885
Is Sole Proprietor?:No
Enumeration Date:2017-01-23
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26019199A183500000X
NC14668183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist