GRANITE PHARMACY MISSOULA, LLC (NPI# 1447683651) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447683651 |
| Entity Type | Organization |
| Organization Name | GRANITE PHARMACY MISSOULA, LLC |
| Other Organization Name | GRANITE PHARMACY MISSOULA |
| Practice Address |
2230 27th Ave. West Suite 2 Missoula MT 59804 |
| Practice Telephone | 4069262940 |
| Practice Fax Number | 4069262944 |
| Mailing Telephone | 4069262940 |
| Mailing Fax Number | 4069262944 |
| Enumeration Date | 2013-08-12 |
| Last Update Date | 2014-11-21 |
| Authorized Official Name | ROBERT BEYER (PRESIDENT) |
| Authorized Official Telephone | 4065463090 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
18801 | MT | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MT | DEA NUMBER | FG4086307 | 01 |
| MT | MT PHARMACY LICENSE | PHA-PHR-LIC-18801 | 01 |
| MT | 1447683651 | 05 |
| Other Name | Type Code |
|---|---|
| Granite Pharmacy Missoula | Doing Business As Name - Organization |
| Street Address |
2230 27TH AVE. WEST SUITE 2 |
| City | MISSOULA |
| State | MT |
| Zip Code | 59804 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063019297 | Momentum Speech Therapy, PC | Speech-Language Pathologist | 9885 O'brien Creek Road, Missoula, MT 59804 | 2020-10-01 |
| 1033633037 | Marissa Clark | Genetic Counselor, MS | 2827 Fort Missoula Rd., Suite 317, Missoula, MT 59804 | 2017-08-01 |
| 1104295245 | Scott Richter | Specialist/Technologist | 2892 Ringo Dr, Missoula, MT 59804 | 2015-09-18 |
| 1467860353 | Zachary Ueland | Pharmacist | 4000 Highway 93 South, Missoula, MT 59804 | 2014-07-24 |
| 1316378185 | Tracy Laurel Brothers | Counselor | 1305 Wyoming Street, Missoula, MT 59804 | 2013-12-04 |
| 1871843953 | Autum Emerson Howell | Nurse Practitioner | 2831 Ft. Missoula Rd. Bldg 2, 102, Missoula, MT 59804 | 2012-09-14 |
| 1821353939 | Carlyn Doyle | Nurse Practitioner | 2835 Fort Missoula Rd Ste 203, Missoula, MT 59804 | 2012-07-05 |
| 1396011961 | Patricia Jean Evans | Internal Medicine | 702 S.w. Higgins, First Choice Medical Clinic, Missoula, MT 59804 | 2012-03-28 |
| 1205126794 | Pacific Medical, Inc. | Prosthetic/Orthotic Supplier | 2732 South Ave West, Suite 202, Missoula, MT 59804 | 2011-04-18 |
| 1710286596 | Home Health of Montana Private Services LLC | Clinic/Center | 29 Fort Missoula Road, Missoula, MT 59804 | 2011-03-20 |
| Find all providers in zip 59804 | ||||
| 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 |
| 1184978090 | Credena Health LLC | Pharmacy | 500 W Broadway St, Missoula, MT 59802-4008 | 2012-10-30 |
| 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 |
| Find all providers with the same taxonomy | ||||
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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.