# SHIELDS LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** 406 Clinic Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104378439
- **Authorized official:** ERIC SHIELDS (OWNER/ PIC)
- **Authorized official phone:** (406) 541-4060

## Contact information

- **Practice address:** 1315 WYOMING ST STE A, MISSOULA, MT 59801-1725
- **Practice address phone:** (406) 544-8808
- **Practice address fax:** (406) 541-0185
- **Mailing address:** 4108 LINCOLN RD, MISSOULA, MT 59802-3046
- **Mailing address phone:** (406) 541-4060
- **Mailing address fax:** (406) 541-9699

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336I0012X | Institutional Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | 42790 | MT | Yes |

## Other

- **Enumeration date:** 11/03/2016
- **Last updated:** 03/11/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2166083 | PK | — |