Healthcare Provider Details

I. General information

NPI: 1689841728
Provider Name (Legal Business Name): REBECCA CATHERINE STILLO PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2008
Last Update Date: 10/22/2022
Certification Date: 10/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 WERNER PEAK TRL
KALISPELL MT
59901-6750
US

IV. Provider business mailing address

135 WERNER PEAK TRL
KALISPELL MT
59901-6750
US

V. Phone/Fax

Practice location:
  • Phone: 406-471-4283
  • Fax: 406-862-7432
Mailing address:
  • Phone: 406-471-4283
  • Fax: 406-862-7432

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5835
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: