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Organization
KCS WESTERN DRUG INC
Active
Organization
KCS WESTERN DRUG INC
Active
Other names
Western Drug Long Term Care
Organization subpart
No
Provider details
NPI number
Authorized official
KARI VONDRA (OWNER)
(406) 222-5120
Entity
Organization
Contact information
Practice address
1313 W PARK ST, STE B, LIVINGSTON, MT 59047-2900
(406) 222-5120
(406) 222-7947
Mailing address
1313 W PARK ST, STE B, LIVINGSTON, MT 59047-2900
(406) 222-5120
(406) 222-7947
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
3336L0003X
Long Term Care Pharmacy
Primary
1278
MT
3336L0003X
Long Term Care Pharmacy
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316185218
—
MT
01
—
2783480
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
01/30/2009
Last updated
04/30/2020
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