=====================================================
General NPI Number Information
=====================================================
NPI Number | 1639056393
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PHARM406, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/16/2025
-----------------------------------------------------
Last Update Date | 09/02/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3528 HARRISON AVE
-----------------------------------------------------
City | BUTTE
-----------------------------------------------------
State | MT
-----------------------------------------------------
Zip | 59701-3548
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 406-792-1411
-----------------------------------------------------
Fax | 406-792-1412
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1410 38TH ST W STE A
-----------------------------------------------------
City | BILLINGS
-----------------------------------------------------
State | MT
-----------------------------------------------------
Zip | 59102-7661
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 406-717-6100
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | KYLE AUSTIN
-----------------------------------------------------
Credential | PHARMD
-----------------------------------------------------
Telephone | 406-717-6100
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336L0003X
-----------------------------------------------------
Taxonomy Name | Long Term Care Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------