Individual
DR. QUINCY OSTREM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD, MBA
Contact information
Practice address
100 E IDAHO ST, BOISE, ID 83712-6267
(208) 381-2711
Mailing address
9721 W TELFAIR DR, BOISE, ID 83704-4159
(208) 585-1232
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P8304
ID
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
P8304
ID
1835X0200X
Oncology Pharmacist
P8304
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P8304
IDAHO BOARD OF PHARMACY
ID
01
—
S022981
ARIZONA BOARD OF PHARMACY
AZ
Enumeration date
10/29/2021
Last updated
10/29/2021
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