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General NPI Number Information
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NPI Number | 1912043522
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Entity Type | Organization
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Legal Business Name | MITCHELLS DRUG INC
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 09/12/2007
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Provider Practice Location Address
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Address Line | 125 E GLENDALE ST
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City | DILLON
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State | MT
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Zip | 59725-2505
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Country | US
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Telephone | 406-683-2316
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Fax | 406-683-5182
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Provider Business Mailing Address
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Address Line | PO BOX 145
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City | DILLON
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State | MT
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Zip | 59725-0145
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | THOMAS MITHCELL
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Credential |
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Telephone | 406-683-2316
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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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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 226
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License Number State | MT
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