Provider Demographics
NPI:1417539123
Name:406 RX PLLC
Entity Type:Organization
Organization Name:406 RX PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:406-207-8043
Mailing Address - Street 1:PO BOX 1469
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:MT
Mailing Address - Zip Code:59019-1469
Mailing Address - Country:US
Mailing Address - Phone:406-207-8043
Mailing Address - Fax:406-780-8021
Practice Address - Street 1:407 MAIN ST
Practice Address - Street 2:
Practice Address - City:DEER LODGE
Practice Address - State:MT
Practice Address - Zip Code:59722-1058
Practice Address - Country:US
Practice Address - Phone:406-846-2120
Practice Address - Fax:406-846-2348
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-22
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy