Provider Demographics
NPI:1346633880
Name:FOSTER, BRYAN (RPH)
Entity Type:Individual
Prefix:MR
First Name:BRYAN
Middle Name:
Last Name:FOSTER
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 1:1020 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-0514
Mailing Address - Country:US
Mailing Address - Phone:425-998-6040
Mailing Address - Fax:
Practice Address - Street 1:1020 MAPLE ST
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-0514
Practice Address - Country:US
Practice Address - Phone:425-998-6040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-09
Last Update Date:2015-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT3665183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist