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Suppliers Pharmacy Compounding Pharmacy

Provider NPI: 1851691208

Organization Information:
Organization is not Subpart
Authorized Official:  H. DEAN  MIKES  DIRECTOR OF PHARMACY  406-327-4041

Practice Location:
Tel: 406-327-4680  Fax: 406-327-4679

Business Mailing Address:
Tel: 406-327-4680  Fax: 406-327-4679

NPI Information:
NPI: 1851691208
Entity Type: Organization


PrimaryCodeCategory/DescriptionStateLicense Number
Compounding Pharmacy

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 3336C0003X





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