Healthcare Provider Details

I. General information

NPI: 1821834938
Provider Name (Legal Business Name): STEVE T FLYNN PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2024
Last Update Date: 07/08/2024
Certification Date: 07/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4145 W PATEL DR
MERIDIAN ID
83646-9065
US

IV. Provider business mailing address

975 KIRMAN AVE
RENO NV
89502-0993
US

V. Phone/Fax

Practice location:
  • Phone: 208-297-8168
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberP8405
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: