Healthcare Provider Details

I. General information

NPI: 1427134477
Provider Name (Legal Business Name): BUNDY MANAGEMENT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 02/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3194 HWY 83
SEELEY LAKE MT
59868
US

IV. Provider business mailing address

ONE 7TH AVE EAST
POLSON MT
59860
US

V. Phone/Fax

Practice location:
  • Phone: 406-677-2424
  • Fax: 406-677-3333
Mailing address:
  • Phone: 406-883-0565
  • Fax: 406-883-0761

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number5221
License Number StateMT

VIII. Authorized Official

Name: MISS VICKEE LEE SIEMERS
Title or Position: PRESEIDENT/OWNER
Credential: RPH
Phone: 406-883-0565