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ENNIS PHARMACY AND YESTERDAY'S SODA FOUNTAIN INC NPI 1932241700


NPI Information

NPI: 1932241700
Provider Name: ENNIS PHARMACY AND YESTERDAY'S SODA FOUNTAIN, INC

Doing Business As: ENNIS HEALTH MART PHARMACY

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

Address:
124 EAST MAIN STREET
ENNIS, MT
ZIP 59729
Phone: (406) 682-4246
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ENNIS PHARMACY AND YESTERDAY'S SODA FOUNTAIN, INC is a community/retail pharmacy pharmacy in Ennis, MT. The provider is 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. ENNIS PHARMACY AND YESTERDAY'S SODA FOUNTAIN, INC NPI is 1932241700. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Ennis Health Mart Pharmacy.

The provider's business location address is:

124 EAST MAIN STREET
ENNIS, MT
ZIP 59729-306
Phone: (406) 682-4246
Fax: (406) 682-7568

The provider's authorized official is Stacy A Croy .
The authorized official title is Pharmacy Technician/owner and has the following contact phone number (406) 682-4246.

The enumeration date for this NPI number is 2/12/2007 and was last updated on 2/8/2024.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1183500000XPharmacist807MONTANANo
23336L0003XPharmacyLong Term Care PharmacyNo
33336C0003XPharmacyCommunity/Retail PharmacyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1221377MEDICAIDMONTANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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