Organization
JAK SHIELDS, LLC
Active
Other names
Montana Rx Compounders
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY MARIE SHIELDS PHARM.D (OWNER/PIC)
(406) 542-2888
Entity
Organization
Contact information
Practice address
111 N HIGGINS AVE STE 5, MISSOULA, MT 59802-4494
(406) 542-2888
(406) 542-9380
Mailing address
111 N HIGGINS AVE STE 101, MISSOULA, MT 59802-4437
(406) 542-2888
(406) 542-9380
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
Primary
—
—
Other
Enumeration date
12/21/2021
Last updated
03/08/2023
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