Organization
GRANITE PHARMACY LLC
Active
Organization
GRANITE PHARMACY LLC
Active
Other names
Granite Pharmacy, Granite Pharmacy Philipsburg
Organization subpart
No
Provider details
NPI number
Authorized official
TINA KOERNER (PRESIDENT)
(406) 926-2941
Entity
Organization
Contact information
Practice address
107 S HOLLAND ST, PHILIPSBURG, MT 59858-7609
(406) 859-3784
(406) 859-4412
Mailing address
2230 27TH AVE, MISSOULA, MT 59804-5126
(406) 926-2941
(844) 589-6696
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
1316
MT
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1417264649
—
MT
01
—
2126587
PK
—
Enumeration date
09/09/2010
Last updated
06/29/2026
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