| NPI | 1134746605 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALYSE WEBBER Member 406-778-2214 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2020-07-01 |
| Last Update Date | 2023-09-27 |