Organization
MISSION DRUG LLC
Active
Other names
MISSION DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CORY BENJAMIN ADAMS PHARM D (OWNER/PIC)
(406) 600-7832
Entity
Organization
Contact information
Practice address
110 N MAIN ST, ST IGNATIUS, MT 59865-9031
(406) 745-3000
(406) 745-3003
Mailing address
PO BOX 610, ST IGNATIUS, MT 59865-0610
(406) 745-3000
(406) 745-3003
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
1345
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0212407
—
MT
01
—
2703848
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
09/22/2006
Last updated
04/28/2021
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