Provider Demographics
NPI:1346439957
Name:MILK RIVER PHARMACY INC
Entity Type:Organization
Organization Name:MILK RIVER PHARMACY INC
Other - Org Name:MILK RIVER PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HILARY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:KRASS-RICHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH, PHARMD
Authorized Official - Phone:406-353-3535
Mailing Address - Street 1:PO BOX 965
Mailing Address - Street 2:
Mailing Address - City:HARLEM
Mailing Address - State:MT
Mailing Address - Zip Code:59526-0965
Mailing Address - Country:US
Mailing Address - Phone:406-353-3535
Mailing Address - Fax:406-353-2727
Practice Address - Street 1:42465 US HIGHWAY 2
Practice Address - Street 2:
Practice Address - City:HARLEM
Practice Address - State:MT
Practice Address - Zip Code:59526
Practice Address - Country:US
Practice Address - Phone:406-353-3535
Practice Address - Fax:406-353-2727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-19
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2052655OtherPK
MT1346439957Medicaid