Healthcare Provider Details

I. General information

NPI: 1689822504
Provider Name (Legal Business Name): LAUREN CORCORAN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2008
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

RR 1 BOX 664
BOX ELDER MT
59521-9797
US

IV. Provider business mailing address

6850 UPPER BOX ELDER RD
BOX ELDER MT
59521-9073
US

V. Phone/Fax

Practice location:
  • Phone: 406-395-4150
  • Fax: 406-395-4408
Mailing address:
  • Phone: 406-395-1852
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number5673
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: