| NPI | 1144883984 |
|---|---|
| Doing Business As | BLACKTAIL PHARMACY |
| Entity Type | Organization |
| Authorized Contact | TAMMY COX Pharmacy Director 406-496-6033 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2019-04-17 |
| Last Update Date | 2022-06-10 |