Individual
DR. BRENNAN DUANE BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
175 E OREGON AVE, CRESWELL, OR 97426-9674
(541) 895-2413
(541) 895-2436
Mailing address
884 RIVER RD, EUGENE, OR 97404-3233
(541) 636-3522
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
RPH-0012763
OR
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
RPH-0012763
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RPH-0012763
STATE PHARMACIST LICENSE
OR
Enumeration date
02/15/2012
Last updated
07/21/2022
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