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NPI Code Detail

MEDICARE: MITCHELLS DRUG INC

MEDICARE: MITCHELLS DRUG 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
1333600000XPharmacy
23336C0003XCommunity/Retail Pharmacy226MT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
22700892OTHEROTHER ID NUMBER-COMMERCIAL NUMBER
32700892OTHEROTHER ID NUMBER

General Provider Information

NPI Number : 1912043522
Entity Type Code : Organization
Provider Name (Legal Business Name) : MITCHELLS DRUG INC
Provider Business Mailing Address
First Line : PO BOX 145
Second Line :
City : DILLON
State : MT
Zip : 59725-0145
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 125 E GLENDALE ST
Second Line :
City : DILLON
State : MT
Zip : 59725-2505
Country : US
Telephone Number : 406-683-2316
Fax Number : 406-683-5182
Authorized Official
Title or Position : PRESIDENT
Name : THOMAS MITHCELL
Credential :
Telephone Number : 406-683-2316
Provider Enumeration Date : 01/30/2007
Last Update Date : 09/12/2007

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Directions to “MITCHELLS DRUG INC ” Practice Location

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