| NPI | 1265907299 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE CHOSA Pharmacist In Charge 406-867-4141 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Enumeration Date | 2018-10-05 |
| Last Update Date | 2022-05-19 |