Healthcare Provider Details

I. General information

NPI: 1679870430
Provider Name (Legal Business Name): PHARMFILL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2011
Last Update Date: 01/10/2024
Certification Date: 01/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 CENTRAL AVE N
HARLOWTON MT
59036-5071
US

IV. Provider business mailing address

206 STONER LOOP
LAKESIDE MT
59922-8503
US

V. Phone/Fax

Practice location:
  • Phone: 406-632-4532
  • Fax: 406-632-5674
Mailing address:
  • Phone: 406-844-2103
  • Fax: 406-844-2106

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 NumberPHA-PHR-LIC-24556
License Number StateMT

VIII. Authorized Official

Name: JUSTIN VANCAMPEN
Title or Position: PHARMACIST/OWNER
Credential: PHARMD
Phone: 406-632-4532