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NPI Code Detail

MEDICARE: MR. ROBERT CONWAY MANN

MEDICARE: MR. ROBERT CONWAY MANN
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
1183500000XPharmacist2348MT

General Provider Information

NPI Number : 1568477974
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ROBERT CONWAY MANN
Provider Business Mailing Address
First Line : 105 DENA ST
Second Line :
City : PLENTYWOOD
State : MT
Zip : 59254-2115
Country : US
Telephone Number : 406-765-2288
Fax Number :
Provider Business Practice Location Address
First Line : 119 N MAIN ST
Second Line :
City : PLENTYWOOD
State : MT
Zip : 59254-1817
Country : US
Telephone Number : 406-765-1810
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/31/2006
Last Update Date : 07/08/2007

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Directions to “ MR. ROBERT CONWAY MANN ” Practice Location

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