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Organization
LODGE GRASS HEALTH CENTER PHARMACY
Active
Organization
LODGE GRASS HEALTH CENTER PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CYNTHIA LARSEN (AREA BUSINESS OFFICE COORDINATOR)
(406) 247-7184
Entity
Organization
Contact information
Practice address
HARDING AVE, LODGE GRASS, MT 59050
(406) 639-2317
(406) 639-2976
Mailing address
HARDING AVE, PO BOX 780, LODGE GRASS, MT 59050
(406) 639-2317
(406) 639-2976
Taxonomy
Speciality
Code
Description
License number
State
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2210085
—
MT
01
—
2762955
NCPDP NUMBER
—
Enumeration date
03/05/2007
Last updated
03/07/2023
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