Organization
SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM INC
Active
Other names
Saint Vincent Outpatient Pharmacy, Intermountain Pharmacy # 12
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA ERICKSON (PIC, AO)
(406) 237-8115
Entity
Organization
Contact information
Practice address
1233 N 30TH ST, STE W103, BILLINGS, MT 59101-0127
(406) 237-8117
(406) 237-8139
Mailing address
PO BOX 912960, DENVER, CO 80291-2690
(406) 237-8117
(406) 237-8144
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHA-PHR-LIC-510
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2176195
PK
—
Enumeration date
03/13/2017
Last updated
01/03/2024
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