Organization
SUPERIOR SPECIALTY PHARMACY OF MONTANA, LLC
Active
Other names
Big Sky IV Care, Big Sky I.V. Care
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID GRADY (PRESIDENT)
(406) 752-0440
Entity
Organization
Contact information
Practice address
560 CASCADE LOOP, SUITE 1, KALISPELL, MT 59901
(406) 752-0440
(406) 752-0443
Mailing address
560 CASCADE LOOP, SUITE 1, KALISPELL, MT 59901
(406) 752-0440
(406) 752-0443
Taxonomy
Speciality
Code
Description
License number
State
163WI0500X
Infusion Therapy Registered Nurse
10706
MT
251F00000X
Home Infusion Agency
10706
MT
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
1144
MT
333600000X
Pharmacy
1144
MT
3336H0001X
Home Infusion Therapy Pharmacy
Primary
1144
MT
3336L0003X
Long Term Care Pharmacy
1144
MT
3336S0011X
Specialty Pharmacy
1144
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0380528
—
MT
05
—
0562530
—
MT
05
—
0562547
—
MT
01
—
308210
BLUE CROSS/SHIELD MT
MT
Enumeration date
10/03/2006
Last updated
07/28/2025
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