Provider Demographics
NPI:1932762515
Name:MARIAS HEALTHCARE SERVICES INC
Entity Type:Organization
Organization Name:MARIAS HEALTHCARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:F
Authorized Official - Last Name:BROWNELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-434-3110
Mailing Address - Street 1:1950 W ROOSEVELT HWY STE 2
Mailing Address - Street 2:
Mailing Address - City:SHELBY
Mailing Address - State:MT
Mailing Address - Zip Code:59474-1549
Mailing Address - Country:US
Mailing Address - Phone:406-434-3100
Mailing Address - Fax:406-434-3143
Practice Address - Street 1:1950 W ROOSEVELT HWY
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:MT
Practice Address - Zip Code:59474-1549
Practice Address - Country:US
Practice Address - Phone:406-966-7120
Practice Address - Fax:406-966-7123
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MARIAS HEALTHCARE SERVICES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-04-18
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT58925OtherMONTANA LICENSE
MT58723OtherMONTANA PHARMACY APPLICATION