Provider Demographics
NPI:1457437402
Name:BUNDY MANAGEMENT INC
Entity Type:Organization
Organization Name:BUNDY MANAGEMENT INC
Other - Org Name:HEALTHCARE PLUS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:VICKEE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:SIEMERS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:406-883-0565
Mailing Address - Street 1:ONE 7TH AVE EAST
Mailing Address - Street 2:
Mailing Address - City:POLSON
Mailing Address - State:MT
Mailing Address - Zip Code:59860
Mailing Address - Country:US
Mailing Address - Phone:406-883-0565
Mailing Address - Fax:406-883-0761
Practice Address - Street 1:1900 N 1ST ST
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:MT
Practice Address - Zip Code:59840-3115
Practice Address - Country:US
Practice Address - Phone:406-363-6203
Practice Address - Fax:406-363-7583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT11063336C0003X
3336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT2704814OtherNABP/NCPDP
MT230594Medicaid
MT011002328OtherMEDICARE PTAN
MT0252900001Medicare ID - Type UnspecifiedMEDICARE