MEDICARE: ANDERSON FAMILY PHARMACY INC

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
1	333600000X	Pharmacy
2	3336C0004X	Compounding Pharmacy
3	3336L0003X	Long Term Care Pharmacy
4	3336C0003X	Community/Retail Pharmacy	PHA-PHR-LIC32462	MT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2050157	OTHER		PK

General Provider Information

NPI Number	:	1699786103
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANDERSON FAMILY PHARMACY INC

Provider Business Mailing Address
First Line	:	2828 10TH AVE S
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59405-3241
Country	:	US
Telephone Number	:	406-261-3102
Fax Number	:	406-216-3103

Provider Business Practice Location Address
First Line	:	2828 10TH AVE S
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59405-3241
Country	:	US
Telephone Number	:	406-261-3102
Fax Number	:	406-216-3103

Authorized Official
Title or Position	:	OWNER
Name	:	STUART ANDERSON
Credential	:
Telephone Number	:	406-216-3102

Provider Enumeration Date	:	08/10/2006
Last Update Date	:	04/27/2021

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Directions to “ANDERSON FAMILY PHARMACY INC ” Practice Location

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