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General NPI Number Information
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NPI Number | 1285517268
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Entity Type | Organization
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Legal Business Name | SUPERIOR SPECIALTY PHARMACY OF MONTANA, LLC
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Dates
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Enumeration Date | 07/28/2025
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 630 N LAST CHANCE GULCH STE 1100 ROOM 1111
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City | HELENA
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State | MT
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Zip | 59601-3551
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Country | US
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Telephone | 406-752-0440
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Fax |
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Provider Business Mailing Address
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Address Line | 630 N LAST CHANCE GULCH STE 1100 STE 1100 ROOM 1111
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City | HELENA
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State | MT
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Zip | 59601-3551
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | GENERAL MANAGER
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Name | HEATHER PEACOCK
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Credential | VA
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Telephone | 406-752-0440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number |
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License Number State |
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