Glacier Ridge Pharmacy

LBN: Glacier Ridge Pharmacy Inc
Glacier Ridge Pharmacy is an health care organization with primary practice located at 55 1St Avenue East N , Kalispell MT 59901-4001. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Glacier Ridge Pharmacy Inc can be contacted via phone (406) 755-7979, or through Wilkonski-Larson, Renee via phone (406) 370-9877.

Contact Information

Primary practice address
55 1St Avenue East N Kalispell MT 59901-4001
Fax: (406) 755-7981
Website:
Authorized official contact:
Name: Wilkonski-Larson, Renee RPH

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 1288 Montana
Suppliers / Long Term Care Pharmacy 3336L0003X

Profile Details

NPI number 1205062098
LBN Legal business name Glacier Ridge Pharmacy Inc
DBA Doing business as Glacier Ridge Pharmacy
Authorized official Wilkonski-Larson, Renee RPH
Entity Organization
Organization subpart 1 No
Enumeration date Jun 7th, 2009
Last updated Sep 18th, 2009 - about 16 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 1205062098 NPPES
Other 2783531 NCPDP PROVIDER IDENTIFICATION NUMBER
MEDICAID 1205062098 NCPDP PROVIDER IDENTIFICATION NUMBER

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