Organization
VENDOR PRO CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TYLER D BOHANNON (MANAGER)
(406) 219-1922
Entity
Organization
Contact information
Practice address
1627 W MAIN ST., SUITE 446, BOZEMAN, MT 59715-4011
(406) 219-1922
(406) 219-1953
Mailing address
1627 W MAIN ST., SUITE 446, BOZEMAN, MT 59715-4011
(406) 219-1922
(406) 219-1953
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
333600000X
Pharmacy
PHA-WDD-LIC-21852
MT
Other
Enumeration date
12/17/2013
Last updated
05/26/2020
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