Provider Demographics
NPI:1629724596
Name:MT FAMILY RX INC.
Entity Type:Organization
Organization Name:MT FAMILY RX INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST/ OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LEVI
Authorized Official - Middle Name:DONALD
Authorized Official - Last Name:SHYPKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:406-239-1277
Mailing Address - Street 1:3804 EASTSIDE HWY
Mailing Address - Street 2:
Mailing Address - City:STEVENSVILLE
Mailing Address - State:MT
Mailing Address - Zip Code:59870-2224
Mailing Address - Country:US
Mailing Address - Phone:406-777-5002
Mailing Address - Fax:406-777-6924
Practice Address - Street 1:3804 EASTSIDE HWY
Practice Address - Street 2:
Practice Address - City:STEVENSVILLE
Practice Address - State:MT
Practice Address - Zip Code:59870-2224
Practice Address - Country:US
Practice Address - Phone:406-777-5002
Practice Address - Fax:406-777-6924
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-01
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0004XSuppliersPharmacyCompounding Pharmacy