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General NPI Number Information
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NPI Number | 1841588316
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Entity Type | Individual
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Provider Name | LARRY BRIAN JOHNSON RPH
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Gender | Male
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Dates
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Enumeration Date | 07/18/2011
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Last Update Date | 07/18/2011
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Provider Practice Location Address
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Address Line | 37435 MAIN ST
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City | BURNEY
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State | CA
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Zip | 96013-4372
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Country | US
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Telephone | 530-335-4860
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Fax | 530-335-3655
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Provider Business Mailing Address
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Address Line | PO BOX 100
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City | BURNEY
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State | CA
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Zip | 96013-0100
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Country | US
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Telephone | 530-339-1932
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Fax | 530-335-3655
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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 | 26726
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License Number State | CA
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