Organization
WESTERN DRUG PHARMACY
Active
Organization
WESTERN DRUG PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELCEY DIEMERT (OWNER)
(406) 265-9601
Entity
Organization
Contact information
Practice address
123 5TH AVE, STE B, HAVRE, MT 59501-3624
(406) 265-9601
(406) 265-4422
Mailing address
PO BOX 631, HAVRE, MT 59501-0631
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
1137
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0213486
—
MT
01
—
2764226
OTHER ID NUMBER
—
Enumeration date
08/31/2006
Last updated
05/06/2008
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