Provider Demographics
NPI:1407172349
Name:KLOSTER, BRIAN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:
Last Name:KLOSTER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15509 STILLWATER CROSSING LN
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-4684
Mailing Address - Country:US
Mailing Address - Phone:704-281-5658
Mailing Address - Fax:
Practice Address - Street 1:15509 STILLWATER CROSSING LN
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-4684
Practice Address - Country:US
Practice Address - Phone:704-281-5658
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-16
Last Update Date:2010-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC19624183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist