Provider Demographics
NPI:1124398656
Name:ALLISON, JIMMIE D (PHARM D)
Entity Type:Individual
Prefix:
First Name:JIMMIE
Middle Name:D
Last Name:ALLISON
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2120 W PARK ST
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:MT
Mailing Address - Zip Code:59047-4127
Mailing Address - Country:US
Mailing Address - Phone:406-222-1188
Mailing Address - Fax:
Practice Address - Street 1:2120 W PARK ST
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:MT
Practice Address - Zip Code:59047-4127
Practice Address - Country:US
Practice Address - Phone:406-222-1188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-30
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK2064183500000X
MT6636183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist