Provider Demographics
NPI:1922320720
Name:TREIS, CASEY (PHARM D)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:
Last Name:TREIS
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2904 3RD ST NE
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59404-1031
Mailing Address - Country:US
Mailing Address - Phone:406-868-4503
Mailing Address - Fax:
Practice Address - Street 1:1000 3RD ST NW
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59404-4114
Practice Address - Country:US
Practice Address - Phone:406-453-6107
Practice Address - Fax:406-771-7202
Is Sole Proprietor?:No
Enumeration Date:2010-02-19
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT6011183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist