CREDENA HEALTH LLC (NPI# 1184978090) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184978090 |
| Entity Type | Organization |
| Organization Name | CREDENA HEALTH LLC |
| Other Organization Name | CREDENA HEALTH PHARMACY ST. PATRICK |
| Practice Address |
500 W Broadway St Missoula MT 59802-4008 |
| Mailing Address |
Po Box 5936b Portland OR 97228-5936 |
| Practice Telephone | 4063271650 |
| Practice Fax Number | 4063271651 |
| Mailing Telephone | 4063271650 |
| Mailing Fax Number | 4063271651 |
| Enumeration Date | 2012-10-30 |
| Last Update Date | 2019-09-20 |
| Authorized Official Name | DONALD WAYNE ANDERSON (DIRECTOR REIMBURSEMENT ADMIN) |
| Authorized Official Telephone | 4255255392 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| Other Name | Type Code |
|---|---|
| Credena Health Pharmacy St. Patrick | Doing Business As Name - Organization |
| The Broadway Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346850641 | Credena Health LLC | Pharmacy | 1510 Division St Ste 110, Oregon City, OR 97045-1572 | 2020-08-03 |
| 1629618186 | Credena Health LLC | Durable Medical Equipment & Medical Supplies | 3300 Providence Dr Ste 101, Anchorage, AK 99508-4619 | 2020-01-13 |
| 1578049631 | Credena Health LLC | Pharmacy | 4805 Ne Glisan St Ste 11n321, Portland, OR 97213 | 2018-07-12 |
| 1396125399 | Credena Health LLC | Pharmacy | 6348 Ne Halsey St, Suite A, Portland, OR 97213-4720 | 2015-06-04 |
| 1164809778 | Credena Health LLC | Pharmacy | 50331a Us Highway 93, Polson, MT 59860-7046 | 2015-05-04 |
| 1124358239 | Credena Health LLC | Pharmacy | 501 S Buena Vista St Fl 1, Burbank, CA 91505 | 2010-01-12 |
| 1225190408 | Credena Health LLC | Pharmacy | 9155 Sw Barnes Rd Ste 102, Portland, OR 97225-6625 | 2006-12-14 |
| 1568551430 | Credena Health LLC | Pharmacy | 101 W 8th Ave Ste 207653, Spokane, WA 99204 | 2006-10-11 |
| 1235243668 | Credena Health LLC | Pharmacy | 5050 Ne Hoyt St Ste 142, Portland, OR 97213-2956 | 2006-08-19 |
| 1205811601 | Credena Health LLC | Pharmacy | 1140 West La Veta, Orange, CA 92868-3849 | 2005-12-08 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | Credena Health LLC | 6348 Ne Halsey St, Suite A, Portland, OR 97213 |
| Iowa Business Entities | CREDENA HEALTH LLC | 6348 Ne Halsey St. Suite A, Portland, OR 97213 |
| Oregon Corporations, Companies and Business Names | CREDENA HEALTH LLC | 6348 Ne Halsey Street, Suite A, Portland, OR 97213 |
| Washington State Corporations | CREDENA HEALTH LLC | 6348 Ne Halsey St, Suite A, Portland, OR 97213-4720 |
| Virginia Business Entities | CREDENA HEALTH LLC | 1801 Lind Ave Sw Ste 9016, Renton, Washington 98057 |
| Street Address |
500 W BROADWAY ST |
| City | MISSOULA |
| State | MT |
| Zip Code | 59802-4008 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982600359 | Kendra B. Lee | Family Medicine | 500 W Broadway St, Missoula, MT 59802-4008 | 2005-06-21 |
| 1205468725 | Stephanie Elizabeth Carl | Physician Assistant | 500 W Broadway St, Missoula, MT 59802-4008 | 2020-02-12 |
| 1942840483 | Credena Health LLC | Durable Medical Equipment & Medical Supplies | 500 W Broadway St, Missoula, MT 59802-4008 | 2020-01-13 |
| 1346880119 | Kaylyn Casebolt Desrosier | Pharmacist | 500 W Broadway St, Missoula, MT 59802-4008 | 2020-01-09 |
| 1689168049 | Kacia Bundle | Nurse Practitioner | 500 W Broadway St, Missoula, MT 59802-4008 | 2018-06-19 |
| 1114424488 | Hannah Gilliland | Nurse Practitioner | 500 W Broadway St, Missoula, MT 59802-4008 | 2018-04-12 |
| 1386164408 | Sandra Lynn Cummins | Social Worker | 500 W Broadway St, Missoula, MT 59802-4008 | 2017-06-20 |
| 1548797152 | Joseph M Miller | Internal Medicine | 500 W Broadway St, Missoula, MT 59802-4008 | 2017-05-12 |
| 1083147664 | Matthew Mcgady | Physician Assistant | 500 W Broadway St, Missoula, MT 59802-4008 | 2017-04-10 |
| 1982135216 | Meeka Pradeep Gandhi | Pediatrics | 500 W Broadway St, Missoula, MT 59802-4008 | 2017-03-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154945921 | Montana Endoscopy Center, Pllc | Clinic/Center | 1930 W Broadway, Ste B, Missoula, MT 59802 | 2020-06-08 |
| 1194364091 | Tommie Lynn Perusich | Nurse Practitioner | 1120 Cedar St., Missoula, MT 59802 | 2019-12-26 |
| 1386122752 | The Hope Health Alliance, Inc. | Case Management | 314 White House Ln, Missoula, MT 59802 | 2018-07-30 |
| 1881181444 | Carol Anne Lesser | Massage Therapist | 1918 Birch St, Missoula, MT 59802 | 2018-04-19 |
| 1528587581 | Missoula Aids Fund, Inc. | Clinic/Center | 1500 W. Broadway Suite A, Missoula, MT 59802 | 2017-09-11 |
| 1942740667 | Gabrielle Shulman | Counselor | 415 N Higgins Ave Ste 14, Missoula, MT 59802 | 2017-02-28 |
| 1053798736 | Endurance Physio | Clinic/Center | 214 E. Main St, Missoula, MT 59802 | 2015-05-01 |
| 1720481971 | Anna Golding | Counselor | 1325 Wyoming Street, Missoula, MONTANA 59802 | 2014-10-02 |
| 1003255803 | Jennifer Dawn Danielson | Speech-Language Pathologist | 2408 Duncan Drive, Missoula, MT 59802 | 2013-06-14 |
| 1437595725 | Partnership Health Center Inc | Clinic/Center | 1150 Sherwood St, Missoula, MT 59802 | 2013-05-14 |
| Find all providers in zip 59802 | ||||
| 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] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659425718 | Savmor Drug I, Inc. | Pharmacy | 1610 S 3rd St W, Ste 100, Missoula, MT 59801-9012 | 2007-01-23 |
| 1649380262 | Costco Wholesale Corporation | Pharmacy | 3220 N Reserve St, Missoula, MT 59808 | 2006-08-30 |
| 1780135186 | Rosauers Food and Drug #27 | Pharmacy | 2350 S Reserve St, Missoula, MT 59801-6447 | 2016-10-20 |
| 1588062509 | Rchp Billings - Missoula LLC | Pharmacy | 2835 Fort Missoula Rd, Missoula, MT 59804-7423 | 2014-12-08 |
| 1700998705 | Missoula Pharmacy Inc | Pharmacy | 1211 S Reserve St, Ste 102, Missoula, MT 59801-3102 | 2006-08-31 |
| 1972613388 | Credena Health LLC | Pharmacy | 500 W Broadway St, Missoula, MT 59802-4008 | 2006-08-30 |
| 1720011190 | Heffernan Drug Inc | Pharmacy | 918 Sw Higgins Ave, Missoula, MT 59803-3606 | 2006-07-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
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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.