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NPI Code Detail

MEDICARE: BRANDON JASON GUTHRIE PHARMD

MEDICARE: BRANDON JASON GUTHRIE PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistP9411ID

General Provider Information

NPI Number : 1316677180
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRANDON JASON GUTHRIE PHARMD
Provider Business Mailing Address
First Line : 1717 ARLINGTON AVE
Second Line :
City : CALDWELL
State : ID
Zip : 83605-4802
Country : US
Telephone Number : 208-504-8735
Fax Number :
Provider Business Practice Location Address
First Line : 1717 ARLINGTON AVE
Second Line :
City : CALDWELL
State : ID
Zip : 83605-4802
Country : US
Telephone Number : 208-504-8735
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2022
Last Update Date : 02/11/2026

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