Healthcare Provider Details

I. General information

NPI: 1285651935
Provider Name (Legal Business Name): KATHRYN M EBERLING RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 N MAIN ST
PLENTYWOOD MT
59254-1817
US

IV. Provider business mailing address

106 DENA ST
PLENTYWOOD MT
59254-2114
US

V. Phone/Fax

Practice location:
  • Phone: 406-765-1810
  • Fax: 406-765-1811
Mailing address:
  • Phone: 406-765-2351
  • Fax: 406-765-1811

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number3355
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: