Healthcare Provider Details

I. General information

NPI: 1124706502
Provider Name (Legal Business Name): JENEE DARLENE PALUSO PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2023
Last Update Date: 07/06/2023
Certification Date: 07/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

445 CENTENNIAL AVE
BUTTE MT
59701-2870
US

IV. Provider business mailing address

2438 KEEL DR
BILLINGS MT
59105-3605
US

V. Phone/Fax

Practice location:
  • Phone: 406-723-4075
  • Fax:
Mailing address:
  • Phone: 406-209-5379
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License NumberPHA-PHA-LIC-55376
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: