| NPI | 1205904109 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEILA SODERBERG Pres Owner 406-323-1811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: MT 763) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 3336L0003X Pharmacy, Long Term Care Pharmacy | |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2020-08-22 |