Healthcare Provider Details

I. General information

NPI: 1427323138
Provider Name (Legal Business Name): MORGAN CREEK COMPOUNDING PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2012
Last Update Date: 05/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

71 25TH ST W STE 2
BILLINGS MT
59102-4660
US

IV. Provider business mailing address

71 25TH ST W STE 2
BILLINGS MT
59102-4660
US

V. Phone/Fax

Practice location:
  • Phone: 406-294-6227
  • Fax: 406-294-6231
Mailing address:
  • Phone: 406-294-6227
  • Fax: 406-294-6231

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number1346
License Number StateMT

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MS. COLLEEEN A BAKER
Title or Position: OWNER/PHARMACIST
Credential: R.PH.
Phone: 406-294-6227