Provider Demographics
NPI:1619041548
Name:GRIFFITH, JOHN KH (RPH)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:KH
Last Name:GRIFFITH
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 1:300 N WILLSON AVE
Mailing Address - Street 2:1002
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-3551
Mailing Address - Country:US
Mailing Address - Phone:406-587-4597
Mailing Address - Fax:406-587-4598
Practice Address - Street 1:300 N WILLSON AVE
Practice Address - Street 2:1002
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-3551
Practice Address - Country:US
Practice Address - Phone:406-587-4597
Practice Address - Fax:406-587-4598
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT28701835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT2870OtherPHARMACIST