Provider Demographics
NPI:1659763217
Name:MONTANA RX SOLUTIONS, PLLC
Entity Type:Organization
Organization Name:MONTANA RX SOLUTIONS, PLLC
Other - Org Name:COLSTRIP FAMILY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER, MONTANA RX SOLUTIONS, PLLC
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:MATOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:406-860-4044
Mailing Address - Street 1:PO BOX 2
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:MT
Mailing Address - Zip Code:59019-0002
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6230 MAIN ST
Practice Address - Street 2:STE. B101
Practice Address - City:COLSTRIP
Practice Address - State:MT
Practice Address - Zip Code:59323-9520
Practice Address - Country:US
Practice Address - Phone:406-213-7010
Practice Address - Fax:406-213-7009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-19
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTPHA-PHR-LIC-284123336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT1659763217Medicaid