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General NPI Number Information
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NPI Number | 1073653218
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Entity Type | Organization
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Legal Business Name | MONTANA STATE UNIVERSITY
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 02/23/2017
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Provider Practice Location Address
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Address Line | MSU STUDENT HEALTH SERVICE RX 7TH AND GRANT
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City | BOZEMAN
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State | MT
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Zip | 59715-0002
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Country | US
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Telephone | 406-994-5498
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Fax | 406-994-7071
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Provider Business Mailing Address
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Address Line | MSU STUDENT HEALTH SERVICE RX P.O.BOX 173260
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City | BOZEMAN
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State | MT
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Zip | 59717
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Country | US
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Telephone | 406-994-5498
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Fax | 406-994-7071
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | JEAN STERNHAGEN
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Credential | RPH
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Telephone | 406-994-5498
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number | PHA-PHR-LIC-390
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License Number State | MT
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