| NPI | 1679776553 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA STILLO Pharmacy Manager 406-862-2543 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336S0011X Pharmacy, Specialty Pharmacy (Licence: MT 299) |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2020-08-22 |