| NPI | 1790804557 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARLENE RUTLEDGE Fiscal Manager 406-444-4497 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: MT 1195) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2008-06-23 |