| NPI | 1578254942 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETTY COLE Credentialing COO Rdinator 406-455-2172 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 3336S0011X Pharmacy Specialty Pharmacy |
| Enumeration Date | 2023-05-17 |
| Last Update Date | 2023-06-29 |