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General NPI Number Information
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NPI Number | 1811254709
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Entity Type | Individual
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Provider Name | BRIAN ORA MINASIAN PHARM D
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Gender | Male
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Dates
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Enumeration Date | 04/16/2012
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Last Update Date | 04/16/2012
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Provider Practice Location Address
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Address Line | 118 S MIDLAND BLVD
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City | NAMPA
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State | ID
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Zip | 83686-2601
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Country | US
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Telephone | 208-442-1000
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Fax | 208-442-1091
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Provider Business Mailing Address
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Address Line | 119 S VALLEY DR STE A
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City | NAMPA
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State | ID
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Zip | 83686-2985
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Country | US
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Telephone | 208-442-1000
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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 | P4957
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License Number State | ID
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