Organization
THE BROADWAY COMPANY
Active
Other names
Lewistown Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES WILLIAM WICKS RPH (PRESIDENT)
(406) 538-8128
Entity
Organization
Contact information
Practice address
210 W MAIN ST, LEWISTOWN, MT 59457-2702
(406) 538-8128
(406) 535-5331
Mailing address
210 W MAIN ST, LEWISTOWN, MT 59457-2702
(406) 538-8128
(406) 535-5331
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
111
MT
Other
Enumeration date
02/20/2007
Last updated
08/22/2020
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