Organization
KCS WESTERN DRUG INC
Active
Other names
GARDINER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
KARI VONDRA (OWNER)
(406) 222-7332
Entity
Organization
Contact information
Practice address
318 PARK ST, GARDINER, MT 59030-7735
(406) 848-9430
(406) 848-9465
Mailing address
PO BOX 67, GARDINER, MT 59030-0067
(406) 848-9430
(406) 848-9465
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHA-PHR-LIC-27961
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1235534561
—
MT
Enumeration date
01/03/2007
Last updated
12/11/2020
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