Healthcare Provider Details

I. General information

NPI: 1497407613
Provider Name (Legal Business Name): DAVID R O'BRIEN PHARMD, RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/19/2022
Last Update Date: 01/19/2022
Certification Date: 01/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 4TH ST W
HARDIN MT
59034-1802
US

IV. Provider business mailing address

3110 RUGBY DR
BILLINGS MT
59102-0750
US

V. Phone/Fax

Practice location:
  • Phone: 496-867-4141
  • Fax:
Mailing address:
  • Phone: 406-534-4939
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License NumberPHA-PHA-LIC-12476
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: