| NPI | 1114243367 |
|---|---|
| Doing Business As | GREEN BEAN COFFEESHOP |
| Entity Type | Organization |
| Authorized Contact | PHAEDRUS HEMPHILL SWAB Owner 406-541-3465 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site |
| Enumeration Date | 2010-04-13 |
| Last Update Date | 2010-04-13 |