| Organization Name: | GENEVA WOODS PHARMACY, INC. |
| NPI Number: | 1730588146 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DAN AFRASIABI (PRESIDENT) |
| Mailing Address: | 2600 Winne Ave Suite A Helena |
| State: | MT US |
| Postal Code: | 596014900 |
| Phone Number: | 4064430505 |
| Fax Number: | 4064496273 |
| NPI Enumeration Date: | 08/21/2014 |
| NPI Last Update Date: | 05/27/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332B00000X |
| License Number: | PHA-PHR-LIC-20375 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MT |
| 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 |