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Organization
GEORGE A YEATS PC
Active
Organization
GEORGE A YEATS PC
Active
Other names
EVERGREEN COMPOUNDING PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JODY YEATS (CO-OWNER)
(406) 257-2083
Entity
Organization
Contact information
Practice address
2640 HWY 2 EAST, KALISPELL, MT 59901-3227
(406) 257-2083
(406) 755-3219
Mailing address
2640 HWY 2 EAST, KALISPELL, MT 59901-3227
(406) 257-2083
(406) 755-3219
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0004X
Compounding Pharmacy
Primary
1228
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0215186
—
MT
01
—
2051848
PK
—
Enumeration date
06/11/2006
Last updated
02/21/2017
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