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General NPI Number Information
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NPI Number | 1245767656
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Entity Type | Individual
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Provider Name | KENNETH MARTEY PHARM.D
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Gender | Male
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Dates
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Enumeration Date | 05/16/2017
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Last Update Date | 08/30/2022
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Provider Practice Location Address
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Address Line | 7300 N PERIMETER RD
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City | GREAT FALLS
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State | MT
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Zip | 59402-6701
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Country | US
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Telephone | 406-731-1523
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Fax |
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Provider Business Mailing Address
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Address Line | 904 IRONWOOD ST
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City | GREAT FALLS
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State | MT
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Zip | 59405-7953
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Country | US
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Telephone | 813-484-0076
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 31426
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License Number State | FL
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