Healthcare Provider Details

I. General information

NPI: 1104715069
Provider Name (Legal Business Name): PHARM406, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2025
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3528 HARRISON AVE
BUTTE MT
59701-3548
US

IV. Provider business mailing address

1410 38TH ST W STE A
BILLINGS MT
59102-7661
US

V. Phone/Fax

Practice location:
  • Phone: 406-792-1411
  • Fax: 406-792-1412
Mailing address:
  • Phone: 406-262-3098
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: KYLE AUSTIN
Title or Position: PRESIDENT
Credential: PHARMD
Phone: 406-717-6100