Provider Demographics
NPI:1386826154
Name:THIES, HENRY FRITZ (RPH)
Entity Type:Individual
Prefix:MR
First Name:HENRY
Middle Name:FRITZ
Last Name:THIES
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:PO BOX 1363
Mailing Address - Street 2:
Mailing Address - City:CUT BANK
Mailing Address - State:MT
Mailing Address - Zip Code:59427-1363
Mailing Address - Country:US
Mailing Address - Phone:406-873-5631
Mailing Address - Fax:406-873-4714
Practice Address - Street 1:601 WEST MAIN STREET
Practice Address - Street 2:
Practice Address - City:CUT BANK
Practice Address - State:MT
Practice Address - Zip Code:59427
Practice Address - Country:US
Practice Address - Phone:406-873-5631
Practice Address - Fax:406-873-4714
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-03
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT2888183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist