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
106 N MONTGOMERY ST, PHILIPSBURG, MT 59858-7596
(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
05/11/2026
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