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Organization
SUPERIOR SPECIALTY PHARMACY OF MONTANA, LLC
Active
Organization
SUPERIOR SPECIALTY PHARMACY OF MONTANA, LLC
Active
Parent organization
SUPERIOR SPECIALTY PHARMACY OF MONTANA, LLC
Other names
Big Sky Specialty Compoundng, Big Sky Specialty Compounding
Organization subpart
Yes
Provider details
NPI number
Legal business name
SUPERIOR SPECIALTY PHARMACY OF MONTANA, LLC
Authorized official
DAVID GRADY (MANAGING MEMBER/OWNER)
(406) 752-0440
Entity
Organization
Contact information
Practice address
20 FOUR MILE DR STE 4, KALISPELL, MT 59901-2644
(406) 752-0499
(406) 752-0498
Mailing address
1600 WHITEFISH STAGE ROAD, SUITE #2, KALISPELL, MT 59901
(406) 752-0499
(406) 752-0498
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
1209
MT
3336C0004X
Compounding Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2148091
PK
—
Enumeration date
10/22/2014
Last updated
09/23/2019
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