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NPI Code Detail

MEDICARE: KYLIE MCCULLOUGH PHARMD

MEDICARE: KYLIE MCCULLOUGH PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist26161NC
2183500000XPharmacist0022122CO
3183500000XPharmacistPH60955618WA
4183500000XPharmacistPHA-PHA-LIC-102497MT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11528410545OTHERNCBCBS OF NC

General Provider Information

NPI Number : 1528410545
Entity Type Code : Individual
Provider Name (Legal Business Name) : KYLIE MCCULLOUGH PHARMD
Provider Business Mailing Address
First Line : 601 1ST AVE N
Second Line :
City : GREAT FALLS
State : MT
Zip : 59401-2510
Country : US
Telephone Number : 406-454-6973
Fax Number : 406-791-9277
Provider Business Practice Location Address
First Line : 105 6TH ST N
Second Line :
City : GREAT FALLS
State : MT
Zip : 59401-2531
Country : US
Telephone Number : 406-791-7903
Fax Number : 406-791-7998
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/02/2016
Last Update Date : 10/01/2025

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Directions to “ KYLIE MCCULLOUGH PHARMD” Practice Location

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