Provider Demographics
NPI:1144587213
Name:ACP INTERNATIONAL, LLC
Entity Type:Organization
Organization Name:ACP INTERNATIONAL, LLC
Other - Org Name:S & J GALLATIN PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFERY
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:CARVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-599-0986
Mailing Address - Street 1:90 W MADISON AVE
Mailing Address - Street 2:STE 252
Mailing Address - City:BELGRADE
Mailing Address - State:MT
Mailing Address - Zip Code:59714-3955
Mailing Address - Country:US
Mailing Address - Phone:406-599-0986
Mailing Address - Fax:406-599-0986
Practice Address - Street 1:11 W MAIN ST
Practice Address - Street 2:STE 207
Practice Address - City:BELGRADE
Practice Address - State:MT
Practice Address - Zip Code:59714-3700
Practice Address - Country:US
Practice Address - Phone:406-599-0986
Practice Address - Fax:406-599-0986
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-13
Last Update Date:2012-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTPHA-PHR-LIC-1347333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy