Provider Demographics
NPI:1508318205
Name:PUBLIC DRUG CO
Entity Type:Organization
Organization Name:PUBLIC DRUG CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:LEPARD
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:406-453-1497
Mailing Address - Street 1:332 29TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59404-1006
Mailing Address - Country:US
Mailing Address - Phone:406-899-3957
Mailing Address - Fax:
Practice Address - Street 1:324 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59401-3114
Practice Address - Country:US
Practice Address - Phone:406-453-1497
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-28
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT39733336C0003X
FL238793336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy