Healthcare Provider Details

I. General information

NPI: 1912913575
Provider Name (Legal Business Name): GLASGOW CLINIC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 06/15/2022
Certification Date: 06/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

621 3RD ST S
GLASGOW MT
59230-2604
US

IV. Provider business mailing address

621 3RD ST S
GLASGOW MT
59230-2604
US

V. Phone/Fax

Practice location:
  • Phone: 406-228-3693
  • Fax: 406-228-3694
Mailing address:
  • Phone: 406-228-3693
  • Fax: 406-228-3694

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number1223
License Number StateMT

VIII. Authorized Official

Name: GREG PAGE
Title or Position: PHARMACIST-IN-CHARGE
Credential: RPH
Phone: 406-672-9588