Provider Demographics
NPI:1275071441
Name:AHS 2 LLC
Entity Type:Organization
Organization Name:AHS 2 LLC
Other - Org Name:LOGAN HEALTH PHARMACY - MEDICAL ARTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ABEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-752-1724
Mailing Address - Street 1:209 CONWAY DR
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-3111
Mailing Address - Country:US
Mailing Address - Phone:406-752-2492
Mailing Address - Fax:
Practice Address - Street 1:209 CONWAY DR
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-3111
Practice Address - Country:US
Practice Address - Phone:406-752-2492
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AHS2 LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-02-07
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0003X, 3336L0003X
MT428213336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT42821OtherPHARMACY LICENSE STATE OF MONTANA