DR. KACIE K HENDRICKS (NPI# 1104126713) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104126713 |
| Entity Type | Individual |
| Full Name | DR. KACIE K HENDRICKS |
| Credential | PHARMD |
| Practice Address |
40774 Mt Highway 35 Polson MT 59860 |
| Mailing Address |
40774 Mt Highway 35 Polson MT 59860-7745 |
| Practice Telephone | 4068833674 |
| Practice Fax Number | 4068833694 |
| Mailing Telephone | 4068833674 |
| Mailing Fax Number | 4068833694 |
| Enumeration Date | 2010-10-28 |
| Last Update Date | 2018-06-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 5686 | MT | Pharmacy Service Providers |
| Street Address |
40774 MT HIGHWAY 35 |
| City | POLSON |
| State | MT |
| Zip Code | 59860 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477582492 | Safeway Inc | Durable Medical Equipment & Medical Supplies | 40774 Mt Highway 35, Polson, MT 59860-7745 | 2006-07-02 |
| 1639553092 | Katherine Jean Devlin | Pharmacist | 40774 Mt Highway 35, Polson, MT 59860-7745 | 2015-07-16 |
| 1578866190 | Tricia L Campbell | Pharmacist | 40774 Mt Highway 35, Polson, MT 59860-7745 | 2010-12-21 |
| 1518267285 | Dale Stoverud | Pharmacist | 40774 Mt Highway 35, Polson, MT 59860-7745 | 2010-10-28 |
| 1598065195 | Ernest Malden Ratzburg | Pharmacist | 40774 Mt Highway 35, Polson, MT 59860-7745 | 2010-10-28 |
| 1578863171 | Elizabeth Duckworth | Pharmacist | 40774 Mt Highway 35, Polson, MT 59860-7745 | 2010-10-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679095020 | Ashley J Gilham | Registered Nurse | #5 4th Ave E., Polson, MT 59860 | 2017-07-07 |
| 1225585532 | St. Luke Community Hospital | Clinic/Center | 107 Ridgewater Dr., Polson, MT 59860 | 2016-09-02 |
| 1306202163 | Western Montana Mental Health Center | Community Based Residential Treatment Facility, Mental Illness | 7 13th Ave East, Polson, MT 59860 | 2016-01-11 |
| 1154730364 | Wanda L King | Dietitian, Registered | 6 Thirteenth Avenue East, Poslon, MT 59860 | 2014-08-13 |
| 1104255637 | Dacia Lee Antiste-fisher | Counselor | #5 4th Ave. E., Polson, MT 59860 | 2013-11-05 |
| 1154758134 | Richard Pierre | Pharmacy Technician | 5 4th Ave E., Polson, MT 59860 | 2013-10-04 |
| 1154755197 | Wal-mart Stores, Inc | Durable Medical Equipment & Medical Supplies | 36318 Memory Lane, Polson, MT 59860 | 2013-08-27 |
| 1245582022 | Catherine D Addison | Registered Nurse | 5 4th Ave. East, Polson, MT 59860 | 2012-10-04 |
| 1114220787 | Erika Ann Weber | Social Worker | #5 4th Ave. E, Polson, MT 59860 | 2010-12-21 |
| 1942431473 | Lisa L. Scalpane | Counselor | 803 Main Street, Suite C, Polson, MT 59860 | 2009-07-31 |
| Find all providers in zip 59860 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811398290 | Triva Bilile | Pharmacist | 1 7th Ave E Ste C, Polson, MT 59860-3202 | 2014-09-04 |
| 1205237690 | Dawn Garrick | Pharmacist | 50331 Us Highway 93, Ste A, Polson, MT 59860-7046 | 2014-09-04 |
| 1215350061 | Hemlata Shah | Pharmacist | 84 Miriam Way, Polson, MT 59860-4148 | 2014-01-30 |
| 1114248648 | Suzanne T Cannady | Pharmacist | #5 4th Ave E, Polson, MT 59865 | 2010-06-18 |
| 1285241141 | Travis Lee Miller | Pharmacist | 40770 Mt Highway 35, Polson, MT 59860-7745 | 2020-09-25 |
| 1982227443 | Sarah Elizabeth Anderson | Pharmacist | 6 13th Ave E, Polson, MT 59860-5315 | 2020-05-19 |
| 1477039758 | Vincent Blase Burt | Pharmacist | 36318 Memory Ln, Polson, MT 59860-7265 | 2018-07-19 |
| 1669986261 | Terry L. Whitecotton | Pharmacist | 5 4th Ave E, Polson, MT 59860 | 2017-11-20 |
| 1437661113 | Paige J Stone | Pharmacist | 6 13th Ave E, Polson, MT 59860-5315 | 2017-11-02 |
| 1114399490 | David Paul Hebert | Pharmacist | 36318 Memory Ln, Polson, MT 59860-7265 | 2015-10-26 |
| Find all providers in POLSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.