Healthcare Provider Details

I. General information

NPI: 1356794655
Provider Name (Legal Business Name): MICHELLE MEHLING PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2016
Last Update Date: 02/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 SANDY STREET
EKALAKA MT
59324
US

IV. Provider business mailing address

92 MEDICINE ROCKS RD
BAKER MT
59313-9604
US

V. Phone/Fax

Practice location:
  • Phone: 406-775-8730
  • Fax:
Mailing address:
  • Phone: 406-425-0432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number35857
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH5745
License Number StateND
# 3
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPHA-PHA-LIC35857
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: