| NPI | 1407212871 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE CHOSA Pharmacist 406-867-4141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: MT 35282) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2016-01-14 |
| Last Update Date | 2022-05-19 |