Healthcare Provider Details

I. General information

NPI: 1972697779
Provider Name (Legal Business Name): BGC INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 06/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 MAIN ST.
THOMPSON FALLS MT
59873-1028
US

IV. Provider business mailing address

1221 MAIN STREET PO BOX 1028
THOMPSON FALLS MT
59873-1028
US

V. Phone/Fax

Practice location:
  • Phone: 406-827-4349
  • Fax: 406-827-9640
Mailing address:
  • Phone: 406-827-4349
  • Fax: 406-827-9640

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number1095
License Number StateMT

VIII. Authorized Official

Name: STEVEN DOUGLAS SHEAR
Title or Position: MANAGER
Credential: R.PH.
Phone: 406-827-4349