Organization
ROBERT DEAN WILCOX
Active
Other names
LOLO DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT DEAN WILCOX RPH (OWNER)
(406) 273-2322
Entity
Organization
Contact information
Practice address
103 GLACIER DR, LOLO, MT 59847-8700
(406) 273-2322
(406) 273-4208
Mailing address
PO BOX 156, LOLO, MT 59847-0156
(406) 273-2322
(406) 273-4208
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
137
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2702555
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/30/2006
Last updated
03/23/2010
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