Provider Demographics
NPI:1275870909
Name:KNOOP, STEVE (RPH)
Entity Type:Individual
Prefix:MR
First Name:STEVE
Middle Name:
Last Name:KNOOP
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 HARMON ST
Mailing Address - Street 2:
Mailing Address - City:GLENDIVE
Mailing Address - State:MT
Mailing Address - Zip Code:59330-1510
Mailing Address - Country:US
Mailing Address - Phone:406-365-5200
Mailing Address - Fax:406-365-7067
Practice Address - Street 1:307 HARMON ST
Practice Address - Street 2:
Practice Address - City:GLENDIVE
Practice Address - State:MT
Practice Address - Zip Code:59330-1510
Practice Address - Country:US
Practice Address - Phone:406-365-5200
Practice Address - Fax:406-365-7067
Is Sole Proprietor?:No
Enumeration Date:2013-01-15
Last Update Date:2016-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTMT3026183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTMT3026OtherMONTANA STATE PHARMACY