PLENTYWOOD DRUG INC. (NPI# 1073514428) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073514428 |
| Entity Type | Organization |
| Organization Name | PLENTYWOOD DRUG INC. |
| Other Organization Name | PLENTYWOOD REXALL DRUG |
| Practice Address |
119 N Main St Plentywood MT 59254-1817 |
| Practice Telephone | 4067651810 |
| Mailing Telephone | 4067651810 |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2016-01-21 |
| Authorized Official Name | MR. MARVIN A EBERLING (OWNER) |
| Authorized Official Telephone | 4067651810 |
| Authorized Official Credential | R.PH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | 984 | MT | Suppliers |
| N | 332BP3500X |
Durable Medical Equipment & Medical Supplies Specialization: Parenteral & Enteral Nutrition |
984 | MT | Suppliers |
| N | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
984 | MT | Suppliers |
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
984 | MT | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MT | 219219 | 05 | |
| MT | MEDICARE | 1073514428 | 01 |
| Other Name | Type Code |
|---|---|
| PLENTYWOOD REXALL DRUG | Doing Business As Name - Organization |
| Street Address |
119 N MAIN ST |
| City | PLENTYWOOD |
| State | MT |
| Zip Code | 59254-1817 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164691952 | Kristen Kiemele Berntson | Pharmacist | 119 N Main St, Plentywood, MT 59254-1817 | 2008-02-26 |
| 1568477974 | Robert Conway Mann | Pharmacist | 119 N Main St, Plentywood, MT 59254-1817 | 2006-07-31 |
| 1003837592 | Marvin A. Eberling | Pharmacist | 119 N Main St, Plentywood, MT 59254-1817 | 2006-07-21 |
| 1285651935 | Kathryn M Eberling | Pharmacist | 119 N Main St, Plentywood, MT 59254-1817 | 2006-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831528421 | Rachel Hart Howard | Physical Therapist | 440 West Laurel Ave, Plentywood, MT 59254 | 2013-11-05 |
| 1871722645 | Gina Elizabeth Aasheim | Counselor | 110 Grant St Ste B, Plentywood, MT 59254 | 2009-07-14 |
| 1942244983 | Amber Marie Skorpil | Physician Assistant | 448 W Laurel Ave, Plentywood, MT 59254 | 2006-06-16 |
| 1629013750 | Kirk L Stoner | Family Medicine | 448 W Laurel Ave, Plentywood, MT 59254 | 2006-06-20 |
| 1750700068 | Susan E. Kavon | Dental Hygienist | 130 Country Club Ave, Plentywood, MT 59254-1500 | 2014-04-15 |
| 1518355817 | Montana Vamc | Clinic/Center | 440 West Laurel Avenue, Plentywood, MT 59254-1526 | 2015-01-08 |
| 1467452102 | Sheridan Memorial Hospital Association | General Acute Care Hospital | 440 W Laurel Ave, Plentywood, MT 59254-1526 | 2005-07-22 |
| 1790331015 | Vallie Christensen | Nurse Practitioner | 440 W Laurel Ave, Plentywood, MT 59254-1526 | 2019-08-13 |
| 1437628567 | Archana Kayastha | Nurse Practitioner | 440 W Laurel Ave, Plentywood, MT 59254-1526 | 2018-11-19 |
| 1740728104 | Jenna Thomas | Nurse Practitioner | 440 W Laurel Ave, Plentywood, MT 59254-1526 | 2017-02-06 |
| Find all providers in zip 59254 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
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|---|---|---|---|---|
| 1023630662 | Pharm406 Inc | Pharmacy | 1410 38th St W Ste A, Billings, MT 59102-7552 | 2020-05-16 |
| 1710521679 | Billmont Rx, LLC | Pharmacy | 1603 Grand Ave Ste 250, Billings, MT 59102-3000 | 2019-11-04 |
| 1235636689 | Daniel Patrick Doran | Pharmacy | 590 Stockett Rd, Sand Coulee, MT 59472-9745 | 2018-04-11 |
| 1477069193 | 406 Rx Pllc | Pharmacy | 117 N Main St Ste A, Three Forks, MT 59752-9013 | 2017-12-18 |
| 1508385477 | Jkw & Jira Inc. | Pharmacy | 1245 N 29th St Ste 100, Billings, MT 59101 | 2017-09-12 |
| 1326564857 | Billings Clinic Specialty Supplies and Services, LLC | Pharmacy | 1015 Broadwater Ave Ste 101, Billings, MT 59102 | 2017-08-16 |
| 1679977433 | Superior Specialty Pharmacy of Montana, LLC | Pharmacy | 20 Four Mile Dr Ste 4, Kalispell, MT 59901-2644 | 2014-10-22 |
| 1134439797 | Kc Western Drug | Pharmacy | 105 E 1st, Clyde Park, MT 59018-0000 | 2010-10-18 |
| 1669795647 | Broadus Foods, Inc | Pharmacy | 120 S Park Avenue, Broadus, MT 59317-0549 | 2010-03-05 |
| 1316135940 | Rosauers Supermarkets Inc | Pharmacy | 3255 Technology Blvd W, Bozeman, MT 59718-6854 | 2007-10-09 |
| Find all providers with the same taxonomy | ||||
| City | PLENTYWOOD |
| Zip Code | 59254 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.