| NPI | 1861933764 |
|---|---|
| Doing Business As | INTERMOUNTAIN PHARMACY # 12 |
| Other Name | SAINT VINCENT OUTPATIENT PHARMACY |
| Entity Type | Organization |
| Authorized Contact | MARIA ERICKSON PIC, AO 406-237-8115 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MT PHA-PHR-LIC-510) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 333600000X Pharmacy | |
| Enumeration Date | 2017-03-13 |
| Last Update Date | 2024-01-03 |