# SOUTH HILLS PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SOUTH HILLS PHARMACY INC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639190689
- **Authorized official:** RON BERGUM (PRESIDENT)
- **Authorized official phone:** (406) 443-2540

## Contact information

- **Practice address:** 2600 WINNE AVE, HELENA, MT 59601-4900
- **Practice address phone:** (406) 443-2540
- **Practice address fax:** (406) 443-2071
- **Mailing address:** PO BOX 6487, HELENA, MT 59604-6487
- **Mailing address phone:** (406) 443-2540
- **Mailing address fax:** (406) 443-2071

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | 20376 | MT | Yes |

## Other

- **Enumeration date:** 07/22/2006
- **Last updated:** 01/02/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0000129047 | — | MT |
| 01 | — | 2052587 | PK | — |