SUPERIOR SPECIALTY PHARMACY OF MONTANA, LLC (NPI# 1679977433) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679977433 |
| Entity Type | Organization |
| Organization Name | SUPERIOR SPECIALTY PHARMACY OF MONTANA, LLC |
| Other Organization Name | BIG SKY SPECIALTY COMPOUNDNG |
| Practice Address |
20 Four Mile Dr Ste 4 Kalispell MT 59901-2644 |
| Mailing Address |
1600 Whitefish Stage Road Suite #2 Kalispell MT 59901 |
| Practice Telephone | 4067520499 |
| Practice Fax Number | 4067520498 |
| Mailing Telephone | 4067520499 |
| Mailing Fax Number | 4067520498 |
| Enumeration Date | 2014-10-22 |
| Last Update Date | 2019-09-23 |
| Authorized Official Name | DAVID GRADY (MANAGING MEMBER/OWNER) |
| Authorized Official Telephone | 4067520440 |
| Is Organization Subpart | Y |
| Parent Organization Name | SUPERIOR SPECIALTY PHARMACY OF MONTANA, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
1209 | MT | Suppliers |
| Y | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2148091 | 01 |
| Other Name | Type Code |
|---|---|
| Big Sky Specialty Compounding | Doing Business As Name - Organization |
| Big Sky Specialty Compoundng | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760576714 | Superior Specialty Pharmacy of Montana, LLC | Registered Nurse | 20 Four Mile Dr, Suite 3, Kalispell, MT 59901-2632 | 2006-10-03 |
| Street Address |
20 FOUR MILE DR STE 4 |
| City | KALISPELL |
| State | MT |
| Zip Code | 59901-2644 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982226650 | Mountain Physical Therapy and Fitness Center LLC | Physical Medicine & Rehabilitation | 2593 Highway 2 East, Suite 6, Kalispell, MT 59901 | 2020-05-15 |
| 1164058350 | Jessica Leeann Abell | Physical Therapist | 1825 Highway 93 S. Suite C, Kalispell, MT 59901 | 2020-03-19 |
| 1588216535 | Diversified Therapeutic Services, Pllc | Clinic/Center | 30 E Washinton St, Suite A, Kalispell, MT 59901 | 2019-07-10 |
| 1467986216 | Jill Shaver | Counselor | 285 2nd Avenue Wn, Suite #100, Kalispell, MT 59901 | 2017-04-19 |
| 1003270810 | Angela Otto | Counselor | 17 2nd St E Ste 204, Kalispell, MT 59901 | 2016-04-07 |
| 1548626989 | Pamela Greskowiak | Counselor | 2282 Hwy 93 South, Suite #1, Kalispell, MT 59901 | 2016-01-14 |
| 1063894921 | Joel Booth | Dentist | 690 N Meridian Rd Ste 106, Kalispell, MT 59901 | 2015-06-26 |
| 1982085841 | Heather Reddig | Specialist | 751 Snowberry Trail, Kalispell, MT 59901 | 2015-06-16 |
| 1497147193 | Patricia Greene Hall | Psychologist | 1035 1st Ave W Fl 3, Kalispell, MT 59901 | 2015-03-04 |
| 1720478886 | Lori Mariani | Social Worker | 1605 Danielson Road, Kalispell, MT 59901 | 2015-01-28 |
| Find all providers in zip 59901 | ||||
| Taxonomy Code | 3336C0004X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Compounding Pharmacy |
| A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner’s Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice. |
| Notes: Sources: NABP Model Practice Act, Appendix C - Good Compounding Practice, USP <795> and <797>, and Pharmacy Compounding Accreditation Board [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548228976 | Applied Health Services Incorporated | Pharmacy | 200 Conway Dr, Kalispell, MT 59901-3112 | 2006-05-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740618594 | Pinnacle Compounding, Lllp | Pharmacy | 1120 Kensington Ave, Suite E, Missoula, MT 59801-5619 | 2013-10-14 |
| 1427323138 | Morgan Creek Compounding Pharmacy | Pharmacy | 71 25th St W Ste 2, Billings, MT 59102-4660 | 2012-03-13 |
| 1548581960 | Mountain Compounding | Pharmacy | 101 S California St, Suite A, Missoula, MT 59801-1745 | 2010-06-21 |
| 1942442421 | Mining City Compounding Pharmacy | Pharmacy | 327 1/2 S Excelsior Ave, Butte, MT 59701 | 2009-03-31 |
| 1659590172 | Rocky Mountain Pharmacy | Pharmacy | 25 N Willson Ave, Suite C, Bozeman, MT 59715-3585 | 2007-04-24 |
| 1073656849 | Jkw & Jira Inc | Pharmacy | 2900 12th Ave N Ste 110a, Billings, MT 59101-7506 | 2007-02-14 |
| 1457437402 | Bundy Management Inc | Pharmacy | 1900 N 1st St, Hamilton, MT 59840-3115 | 2006-10-31 |
| 1417051764 | Franks Express Drug PC | Pharmacy | 1401 Minnesota Ave, Libby, MT 59923-2309 | 2006-09-08 |
| 1336175959 | Juro's Medical Inc. | Pharmacy | 2043 Grand Ave, Billings, MT 59102-2614 | 2006-06-24 |
| 1447809082 | Express Compounding, LLC | Pharmacy | 2086 Us Highway 93 N Ste 110, Victor, MT 59875-9209 | 2019-09-06 |
| Find all providers with the same taxonomy | ||||
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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.