Provider Demographics
NPI:1386657070
Name:BUNDY MANAGEMENT INC.
Entity Type:Organization
Organization Name:BUNDY MANAGEMENT INC.
Other - Org Name:HEALTHCARE PLUS RETAIL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:VICKEE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:SIEMERS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:406-883-0565
Mailing Address - Street 1:ONE 7TH AVE EAST
Mailing Address - Street 2:SUITE D
Mailing Address - City:POLSON
Mailing Address - State:MT
Mailing Address - Zip Code:59860
Mailing Address - Country:US
Mailing Address - Phone:406-883-0565
Mailing Address - Fax:406-883-1878
Practice Address - Street 1:ONE 7TH AVE EAST
Practice Address - Street 2:SUITE D
Practice Address - City:POLSON
Practice Address - State:MT
Practice Address - Zip Code:59860
Practice Address - Country:US
Practice Address - Phone:406-883-0565
Practice Address - Fax:406-883-1878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT325043336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT212342Medicaid
MT0011002328OtherMEDICARE PTAN
MT0011002328OtherMEDICARE PTAN