Provider Demographics
NPI:1366654816
Name:TOSTENRUD, PAULINE (RPH)
Entity Type:Individual
Prefix:
First Name:PAULINE
Middle Name:
Last Name:TOSTENRUD
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:PAULINE
Other - Middle Name:
Other - Last Name:TOSTENRUD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:2009 ST ANDREWS DR
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59105-3628
Mailing Address - Country:US
Mailing Address - Phone:406-256-5355
Mailing Address - Fax:
Practice Address - Street 1:2009 ST ANDREWS DR
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59105-3628
Practice Address - Country:US
Practice Address - Phone:406-256-5355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT3392183500000X, 1835G0303X, 1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered183500000XPharmacy Service ProvidersPharmacist
Not Answered1835G0303XPharmacy Service ProvidersPharmacistGeriatric
Not Answered1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy