Healthcare Provider Details

I. General information

NPI: 1811617947
Provider Name (Legal Business Name): KAREN LYNN DOVE RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2022
Last Update Date: 08/30/2022
Certification Date: 08/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3027 MT HIGHWAY 83 N
SEELEY LAKE MT
59868-8628
US

IV. Provider business mailing address

PO BOX 930
SEELEY LAKE MT
59868-0930
US

V. Phone/Fax

Practice location:
  • Phone: 406-677-8989
  • Fax: 406-677-8080
Mailing address:
  • Phone: 406-677-8989
  • Fax: 406-677-8080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPHA-PHA-LIC-5820
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: