Organization Name: | MISSOULA FRESH MARKET LLC |
NPI Number: | 1720024359 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ROBERT HASQUET (OWNER - PIC) |
Mailing Address: | 800 W Broadway St Missoula |
State: | MT US |
Postal Code: | 598023944 |
Phone Number: | 4067216009 |
Fax Number: | 4067216021 |
NPI Enumeration Date: | 06/21/2006 |
NPI Last Update Date: | 11/09/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 333600000X |
License Number: | 28282 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MT |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Pharmacy |
Taxonomy Specialization: | |
Taxonomy Definition: | A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |