Healthcare Provider Details

I. General information

NPI: 1417051764
Provider Name (Legal Business Name): FRANKS EXPRESS DRUG PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2006
Last Update Date: 10/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 MINNESOTA AVE
LIBBY MT
59923-2309
US

IV. Provider business mailing address

1401 MINNESOTA AVE
LIBBY MT
59923-2309
US

V. Phone/Fax

Practice location:
  • Phone: 406-293-3784
  • Fax: 406-293-9546
Mailing address:
  • Phone: 406-293-3784
  • Fax: 406-293-9546

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 TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number1129
License Number StateMT
# 4
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: FRANK FAHLAND
Title or Position: OWNER
Credential: RPH
Phone: 406-293-3784