Provider Demographics
NPI:1336674548
Name:RUSHING, DAVID HOUSTON
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:HOUSTON
Last Name:RUSHING
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 CENTRAL AVE W
Mailing Address - Street 2:SUTIE 105
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59404-2874
Mailing Address - Country:US
Mailing Address - Phone:406-452-3713
Mailing Address - Fax:
Practice Address - Street 1:625 CENTRAL AVE W
Practice Address - Street 2:SUTIE 105
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59404-2874
Practice Address - Country:US
Practice Address - Phone:406-452-3713
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-25
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT3547183500000X
UT85679551701183500000X
AZS020529183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist