Organization
CREDENA HEALTH LLC
Active
Organization
CREDENA HEALTH LLC
Active
Other names
Credena Health Pharmacy St. Patrick, The Broadway Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE AMINE SKAFI RPH (AVP PHARMACY)
(575) 650-3396
Entity
Organization
Contact information
Practice address
500 W BROADWAY ST, MISSOULA, MT 59802-4008
(406) 327-1650
(406) 327-1651
Mailing address
PO BOX 2704, PORTLAND, OR 97208-2704
(406) 327-1650
(406) 327-1651
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
213187
—
MT
Enumeration date
08/30/2006
Last updated
08/06/2026
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