Organization
KCS WESTERN DRUG INC
Active
Other names
Western Drug Long Term Care
Organization subpart
No
Provider details
NPI number
Authorized official
KARI VONDRA (OWNER)
(406) 222-5120
Entity
Organization
Contact information
Practice address
1313 W PARK ST, STE B, LIVINGSTON, MT 59047-2900
(406) 222-5120
(406) 222-7947
Mailing address
1313 W PARK ST, STE B, LIVINGSTON, MT 59047-2900
(406) 222-5120
(406) 222-7947
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336L0003X
Long Term Care Pharmacy
Primary
1278
MT
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316185218
—
MT
01
—
2783480
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
01/30/2009
Last updated
04/30/2020
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