| NPI | 1700967288 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES CLOUD Owner 406-642-6040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MT 1119) |
| Additional Taxonomies | 3336M0002X Pharmacy, Mail Order Pharmacy (Licence: MT 1119) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2016-02-18 |