Organization
MONTANA COMPOUNDING PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROY G CALCAGNO RPH (PHARMACIST)
(406) 542-2888
Entity
Organization
Contact information
Practice address
111 N HIGGINS AVE STE 5, MISSOULA, MT 59802-4494
(406) 542-2888
Mailing address
111 N HIGGINS AVE STE 5, MISSOULA, MT 59802-4494
(406) 542-2888
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
892
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000211616
—
MT
Enumeration date
11/30/2006
Last updated
08/22/2020
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