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General NPI Number Information
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NPI Number | 1982821237
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Entity Type | Organization
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Legal Business Name | LIBBY DRUG P.C
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 906 MONTANA AVE
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City | LIBBY
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State | MT
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Zip | 59923-2014
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Country | US
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Telephone | 406-293-3958
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Fax | 406-293-5858
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Provider Business Mailing Address
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Address Line | 906 MONTANA AVE
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City | LIBBY
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State | MT
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Zip | 59923-2014
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Country | US
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Telephone | 406-293-3958
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Fax | 406-293-5858
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Authorized Official
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Title or Position | PHARMACY TECHNICIAN
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Name | MRS. LESLIE ANN JAQUETH
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Credential |
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Telephone | 406-293-3958
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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 | 884
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License Number State | MT
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