Healthcare Provider Details

I. General information

NPI: 1578622528
Provider Name (Legal Business Name): REBECCA M ALLEN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2509 7TH AVE S
GREAT FALLS MT
59405-3030
US

IV. Provider business mailing address

99 STEVENSON RD
FORT SHAW MT
59443-9724
US

V. Phone/Fax

Practice location:
  • Phone: 406-761-1701
  • Fax:
Mailing address:
  • Phone: 406-264-5168
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number4844
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: