Provider Demographics
NPI:1457775306
Name:BOMAN, CRAIG EUGENE (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:CRAIG
Middle Name:EUGENE
Last Name:BOMAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4420 KING AVE E
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-4913
Mailing Address - Country:US
Mailing Address - Phone:406-256-0177
Mailing Address - Fax:406-256-0186
Practice Address - Street 1:4420 KING AVE E
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-4913
Practice Address - Country:US
Practice Address - Phone:406-256-0177
Practice Address - Fax:406-256-0186
Is Sole Proprietor?:No
Enumeration Date:2014-02-13
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT3389183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist