| NPI | 1821641069 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANN CLARK Owner 406-873-0404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2019-07-17 |
| Last Update Date | 2019-07-17 |