Provider Demographics
NPI:1326109679
Name:AUER, BRIAN MORGAN (RPH)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:MORGAN
Last Name:AUER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 16TH AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:LEWISTON
Mailing Address - State:ID
Mailing Address - Zip Code:83501-3768
Mailing Address - Country:US
Mailing Address - Phone:208-743-5528
Mailing Address - Fax:208-746-2785
Practice Address - Street 1:720 16TH AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:LEWISTON
Practice Address - State:ID
Practice Address - Zip Code:83501-3768
Practice Address - Country:US
Practice Address - Phone:208-743-5528
Practice Address - Fax:208-746-2785
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2017-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDP4560183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDP4560OtherSTATE LICENSE NUMBER
WAPH00011696OtherSTATE LICENSE NUMBER