Evergreen Compounding Pharmacy

LBN: George A Yeats Pc
Evergreen Compounding Pharmacy is an health care organization with primary practice located at 2640 Hwy 2 East , Kalispell MT 59901-3227. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Compounding Pharmacy. Suppliers / Compounding Pharmacy is the primary health care specialty. George A Yeats Pc can be contacted via phone (406) 257-2083, or through Yeats, Jody via phone (406) 257-2083.

Contact Information

Primary practice address
2640 Hwy 2 East Kalispell MT 59901-3227
Fax: (406) 755-3219
Website:
Authorized official contact:
Name: Yeats, Jody

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Compounding Pharmacy 3336C0004X 1228 Montana

Profile Details

NPI number 1205878733
LBN Legal business name George A Yeats Pc
DBA Doing business as Evergreen Compounding Pharmacy
Authorized official Yeats, Jody
Entity Organization
Organization subpart 1 No
Enumeration date Jun 11th, 2006
Last updated Feb 21st, 2017 - about 7 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205878733 NPPES
Montana MEDICAID 0215186
Montana Other 2051848

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