Organization
LONG PINE DRUG CO.
Active
Other names
WHITEHALL DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID MICHAEL PETERSON RPH (PHARMACIST IN CHARGE)
(406) 287-3931
Entity
Organization
Contact information
Practice address
29 WEST LEGION ST, WHITEHALL, MT 59759-9758
(406) 287-9294
Mailing address
PO BOX 338, WHITEHALL, MT 59759-0338
(406) 287-9294
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
585
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0566878
—
MT
Enumeration date
03/26/2007
Last updated
08/22/2020
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