Provider Demographics
NPI:1679920029
Name:BROWN, BETH ELLEN
Entity type:Individual
Prefix:MS
First Name:BETH
Middle Name:ELLEN
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 1:120 W 2ND ST
Mailing Address - Street 2:
Mailing Address - City:WELLSTON
Mailing Address - State:OH
Mailing Address - Zip Code:45692-1435
Mailing Address - Country:US
Mailing Address - Phone:740-384-2174
Mailing Address - Fax:740-384-5866
Practice Address - Street 1:120 W 2ND ST
Practice Address - Street 2:
Practice Address - City:WELLSTON
Practice Address - State:OH
Practice Address - Zip Code:45692-1435
Practice Address - Country:US
Practice Address - Phone:740-384-2174
Practice Address - Fax:740-384-5866
Is Sole Proprietor?:No
Enumeration Date:2016-05-16
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician