| NPI | 1316953102 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN LAWRENCE LANE Pharmacy Manager 406-436-2270 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MT 711) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2020-08-22 |