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General NPI Number Information
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NPI Number | 1811089568
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Entity Type | Organization
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Legal Business Name | RO MONTANA
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Dates
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Enumeration Date | 09/29/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1417 9TH ST S SUITE 101A
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City | GREAT FALLS
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State | MT
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Zip | 58405
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Country | US
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Telephone | 406-452-7676
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Fax | 406-452-0435
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Provider Business Mailing Address
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Address Line | 1417 9TH ST S SUITE 101A
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City | GREAT FALLS
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State | MT
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Zip | 58405
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Country | US
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Telephone | 406-452-7676
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Fax | 406-452-0435
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Authorized Official
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Title or Position | PRESIDENT OWNER
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Name | STUART E ANDERSON
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Credential | R PH
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Telephone | 406-761-8781
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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