Healthcare Provider Details

I. General information

NPI: 1275257743
Provider Name (Legal Business Name): FLOYD PEDRO MCMILLAN JR. PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2022
Last Update Date: 09/28/2022
Certification Date: 09/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 H ST
POPLAR MT
59255-7817
US

IV. Provider business mailing address

142 E PLEASANT PRAIRIE RD
FLAXVILLE MT
59222-9540
US

V. Phone/Fax

Practice location:
  • Phone: 406-768-3491
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberP10225
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: