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General NPI Number Information
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NPI Number | 1811121171
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Entity Type | Organization
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Legal Business Name | STOICK DRUG L L C
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Dates
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Enumeration Date | 05/14/2009
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Last Update Date | 05/14/2009
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Provider Practice Location Address
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Address Line | 142 E IDAHO ST
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City | KALISPELL
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State | MT
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Zip | 59901-4012
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Country | US
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Telephone | 406-755-4103
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Fax | 406-755-4105
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Provider Business Mailing Address
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Address Line | PO BOX 637
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City | KALISPELL
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State | MT
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Zip | 59903-0637
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Country | US
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Telephone | 406-755-4103
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Fax | 406-755-4105
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | MRS. KIMBERLY W MURRAY
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Credential | RPH
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Telephone | 406-755-4103
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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 | 1259
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License Number State | MT
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