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Organization

SWEETWATER, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. GABRIEL MCMURRAY (OWNER)
(406) 541-0420
Entity
Organization

Contact information

Practice address
5707 W HARRIER DR, MISSOULA, MT 59808-5345
(406) 541-0420
Mailing address
5707 W HARRIER DR, MISSOULA, MT 59808-5345
(406) 541-0420

Taxonomy

Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
BL20100152
MT

Other

Enumeration date
05/05/2010
Last updated
05/05/2010
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