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NPI Code Detail

MEDICARE: DR. RILEY BRENDEN JOHNSON PHARMD

MEDICARE: DR. RILEY BRENDEN JOHNSON 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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1811574866
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RILEY BRENDEN JOHNSON PHARMD
Provider Business Mailing Address
First Line : 2921 ZION LN APT 106
Second Line :
City : CASPER
State : WY
Zip : 82609-5145
Country : US
Telephone Number : 970-396-0977
Fax Number :
Provider Business Practice Location Address
First Line : 1233 E 2ND ST
Second Line :
City : CASPER
State : WY
Zip : 82601-2988
Country : US
Telephone Number : 307-577-2991
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2021
Last Update Date : 03/25/2021

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