| NPI | 1669508768 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA LARSEN Area Business Office Coordinator 406-247-7184 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332800000X Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2023-03-07 |