MEDICARE: CASEY TREIS PHARM D.

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	183500000X	Pharmacist	6011	MT

General Provider Information

NPI Number	:	1922320720
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CASEY TREIS PHARM D.

Provider Business Mailing Address
First Line	:	2904 3RD ST NE
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59404-1031
Country	:	US
Telephone Number	:	406-868-4503
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 3RD ST NW
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59404-4114
Country	:	US
Telephone Number	:	406-453-6107
Fax Number	:	406-771-7202

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/19/2010
Last Update Date	:	02/19/2010

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Directions to “ CASEY TREIS PHARM D.” Practice Location

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