Healthcare Provider Details

I. General information

NPI: 1811969629
Provider Name (Legal Business Name): BRIAN L. IHLENFELD RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2006
Last Update Date: 05/01/2025
Certification Date: 05/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNITED STATES NAVAL HOSPITAL OKINAWA
FPO AP
96362
US

IV. Provider business mailing address

PSC 482 BOX 2782
FPO AP
96362-0028
US

V. Phone/Fax

Practice location:
  • Phone: 98-971-7714
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03-2-23663
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number03223663
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: