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NPI 1194629212

NPI 1194629212 : BRIAN OSTERMAN PHARM-D : SHELLEY, ID

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General NPI Number Information
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    NPI Number           |    1194629212
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    Entity Type          |    Individual 
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    Provider Name        |    BRIAN OSTERMAN PHARM-D
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    10/03/2026
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    Last Update Date     |    10/03/2026
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Provider Practice Location Address
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    Address Line         |    1384 N 695 E 
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    City                 |    SHELLEY
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    State                |    ID
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    Zip                  |    83274-5061
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    Country              |    US
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    Telephone            |    208-251-3639
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1384 N 695 E 
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    City                 |    SHELLEY
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    State                |    ID
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    Zip                  |    83274-5061
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    183500000X
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    Taxonomy Name        |    Pharmacist
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    License Number       |    P6103
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    License Number State |    ID
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