Provider Demographics
NPI:1700162047
Name:BARTLETT, RITA R (RPH)
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:R
Last Name:BARTLETT
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 W IDAHO ST
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-3956
Mailing Address - Country:US
Mailing Address - Phone:406-257-0723
Mailing Address - Fax:406-257-1797
Practice Address - Street 1:40 W IDAHO ST
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-3956
Practice Address - Country:US
Practice Address - Phone:406-257-0723
Practice Address - Fax:406-257-1797
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-01
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT3807183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist