Healthcare Provider Details

I. General information

NPI: 1205005451
Provider Name (Legal Business Name): HENRY EVAN GRIFFITH PHARMD; RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2008
Last Update Date: 02/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2475 E BROADWAY ST PHARMACY DEPT
HELENA MT
59601-4928
US

IV. Provider business mailing address

2475 E BROADWAY ST PHARMACY DEPT
HELENA MT
59601-4928
US

V. Phone/Fax

Practice location:
  • Phone: 406-444-2547
  • Fax: 406-447-2407
Mailing address:
  • Phone: 406-444-2547
  • Fax: 406-447-2407

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number4733
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: