Provider Demographics
NPI:1275819203
Name:ENTINGER, BRIAN (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:
Last Name:ENTINGER
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2499 HIGHWAY 7
Mailing Address - Street 2:
Mailing Address - City:EXCELSIOR
Mailing Address - State:MN
Mailing Address - Zip Code:55331-9701
Mailing Address - Country:US
Mailing Address - Phone:952-252-1070
Mailing Address - Fax:952-252-1076
Practice Address - Street 1:2499 HIGHWAY 7
Practice Address - Street 2:
Practice Address - City:EXCELSIOR
Practice Address - State:MN
Practice Address - Zip Code:55331-9701
Practice Address - Country:US
Practice Address - Phone:952-252-1070
Practice Address - Fax:952-252-1076
Is Sole Proprietor?:No
Enumeration Date:2011-10-21
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN117463183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist