Organization
MATOVICH ENTERPRISES INC
Active
Other names
Stillwater Family Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL MATOVICH RPH (OWNER)
(406) 322-5652
Entity
Organization
Contact information
Practice address
133 N 5TH, COLUMBUS, MT 59019
(406) 322-5652
(406) 322-4960
Mailing address
PO BOX 719, COLUMBUS, MT 59019-0719
(406) 322-5652
(406) 322-4960
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHA-PHR-LIC-602
MT
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2050295
PK
—
05
—
212194
—
MT
Enumeration date
01/08/2007
Last updated
06/14/2021
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