Provider Demographics
NPI:1659425718
Name:SAVMOR DRUG I, INC.
Entity Type:Organization
Organization Name:SAVMOR DRUG I, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JILL
Authorized Official - Middle Name:A
Authorized Official - Last Name:MUNOZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-721-6017
Mailing Address - Street 1:1610 S 3RD ST W
Mailing Address - Street 2:STE 100
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801-9012
Mailing Address - Country:US
Mailing Address - Phone:406-721-6017
Mailing Address - Fax:406-721-1006
Practice Address - Street 1:1610 S 3RD ST W
Practice Address - Street 2:STE 100
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-9012
Practice Address - Country:US
Practice Address - Phone:406-721-6017
Practice Address - Fax:406-721-1006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
MT10633336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0214890Medicaid
MT0560167Medicaid
MTBS4339075OtherDEA
MTBS4339075OtherDEA