Organization Name: | GRANITE PHARMACY LLC |
NPI Number: | 1417264649 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ROBERT BEYER (OWNER/PRESIDENT) |
Mailing Address: | 106 N. Montgomery St Philipsburg |
State: | MT US |
Postal Code: | 59858 |
Phone Number: | 4068593784 |
Fax Number: | 4068594412 |
NPI Enumeration Date: | 09/09/2010 |
NPI Last Update Date: | 02/24/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |