Healthcare Provider Details

I. General information

NPI: 1780273565
Provider Name (Legal Business Name): BRIAN THOMAS OPRISIU
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/15/2021
Last Update Date: 01/15/2021
Certification Date: 01/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 SW 37TH ST
TOPEKA KS
66611-2308
US

IV. Provider business mailing address

783 E 1550TH RD
BALDWIN CITY KS
66006-7343
US

V. Phone/Fax

Practice location:
  • Phone: 785-267-6900
  • Fax:
Mailing address:
  • Phone: 231-330-6988
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number1-102344
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: