| NPI | 1104909696 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWNA MARIE YATES Executive Director 406-496-6018 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MT PHA-PHR-LIC-1315) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0004X Pharmacy, Compounding Pharmacy (Licence: MT PHA-PHR-LIC-1315) | |
| 3336L0003X Pharmacy, Long Term Care Pharmacy | |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2022-02-14 |