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General NPI Number Information
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NPI Number | 1639904642
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Entity Type | Individual
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Provider Name | TAIKEN ROST
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Gender | Female
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Dates
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Enumeration Date | 09/09/2024
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Last Update Date | 09/09/2024
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Provider Practice Location Address
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Address Line | 519 S HAYNES AVE
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City | MILES CITY
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State | MT
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Zip | 59301-4768
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Country | US
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Telephone | 406-232-4627
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Fax |
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Provider Business Mailing Address
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Address Line | 202 N CUSTER AVE
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City | MILES CITY
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State | MT
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Zip | 59301-2722
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Country | US
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Telephone | 406-853-5691
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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 | 107993
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License Number State | MT
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