Provider Demographics
NPI:1164972006
Name:SPARLING, MARY E (RPH)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:E
Last Name:SPARLING
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 STEVI CUTOFF RD
Mailing Address - Street 2:
Mailing Address - City:STEVENSVILLE
Mailing Address - State:MT
Mailing Address - Zip Code:59870-6496
Mailing Address - Country:US
Mailing Address - Phone:406-777-4410
Mailing Address - Fax:406-777-4192
Practice Address - Street 1:39 STEVI CUTOFF RD
Practice Address - Street 2:
Practice Address - City:STEVENSVILLE
Practice Address - State:MT
Practice Address - Zip Code:59870-6496
Practice Address - Country:US
Practice Address - Phone:406-777-4410
Practice Address - Fax:406-777-4192
Is Sole Proprietor?:No
Enumeration Date:2016-10-04
Last Update Date:2016-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT6000183500000X
AZ7926183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist