Provider Demographics
NPI:1497960595
Name:MCCALLA, SYLVIA PATTERSON (RPH)
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:PATTERSON
Last Name:MCCALLA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3126 LLOYD MANGRUM LN
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59106-1107
Mailing Address - Country:US
Mailing Address - Phone:406-656-2814
Mailing Address - Fax:406-656-0025
Practice Address - Street 1:1212 GRAND AVE
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-4259
Practice Address - Country:US
Practice Address - Phone:406-248-5544
Practice Address - Fax:406-248-5054
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT2207183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist