Organization
PLAINS REXALL DRUG
Active
Other names
PLAINS DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL LARSON RPH (OWNER)
(406) 826-3552
Entity
Organization
Contact information
Practice address
214 RAILROAD ST, PLAINS, MT 59859
(406) 826-3552
(406) 826-3599
Mailing address
PO BOX 609, PLAINS, MT 59859-0609
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
437
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0215267
—
MT
05
—
0562510
—
MT
01
—
2701995
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/20/2006
Last updated
12/12/2008
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