Organization
VENDOR PRO CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYLER D BOHANNON (PRESIDENT)
(866) 743-8396
Entity
Organization
Contact information
Practice address
804 N 19TH AVE, SUITE 2B, BOZEMAN, MT 59718-6928
(866) 743-8396
Mailing address
804 N 19TH AVE, SUITE 2B, BOZEMAN, MT 59718-6928
(866) 743-8396
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHA-WDD-LIC-21852
MT
Other
Enumeration date
04/30/2014
Last updated
04/30/2014
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