Organization
MINING CITY COMPOUNDING PHARMACY LLC
Active
Other names
Driscoll Drug
Organization subpart
No
Provider details
NPI number
Authorized official
CHAD OCONNELL (OWNER/OPERATOR)
(406) 723-3308
Entity
Organization
Contact information
Practice address
327 S EXCELSIOR AVE, BUTTE, MT 59701-1536
(406) 723-3308
(406) 782-8243
Mailing address
327 S EXCELSIOR AVE, BUTTE, MT 59701-1536
(406) 723-3308
(406) 782-8243
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
21476
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2144257
PK
—
Enumeration date
02/04/2014
Last updated
03/07/2014
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