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General NPI Number Information
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NPI Number | 1508318205
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Entity Type | Organization
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Legal Business Name | PUBLIC DRUG CO
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Dates
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Enumeration Date | 10/28/2016
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Last Update Date | 10/28/2016
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Provider Practice Location Address
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Address Line | 324 CENTRAL AVE
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City | GREAT FALLS
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State | MT
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Zip | 59401-3114
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Country | US
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Telephone | 406-453-1497
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Fax |
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Provider Business Mailing Address
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Address Line | 332 29TH AVE NE
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City | GREAT FALLS
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State | MT
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Zip | 59404-1006
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Country | US
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Telephone | 406-899-3957
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Fax |
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Authorized Official
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Title or Position | OWNER PHARMACIST
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Name | MR. TODD LEPARD
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Credential | RPH
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Telephone | 406-453-1497
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 23879
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 3973
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License Number State | MT
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