Robert Dean Wilcox
Pharmacy, Community/Retail Pharmacy in Lolo, MT. Organization (NPI-2).
NPI number1528073152
StatusActive
Last updated in NPPESMar 23, 2010
Details
- NPI
- 1528073152
- Entity type
- Organization (NPI-2)
- Legal business name
- Robert Dean Wilcox
- Organization subpart
- No
- Enumeration date
- Jul 30, 2006
- Last updated
- Mar 23, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | 137 | MT | Yes |
Other names
- Lolo Drug (Doing Business As)
Practice location
103 Glacier DrLolo, MT 59847-8700
Phone 406-273-2322 · Fax 406-273-4208
Mailing address
Po Box 156Lolo, MT 59847-0156
Phone 406-273-2322 · Fax 406-273-4208
Authorized official
Robert Dean Wilcox
Owner
4062732322
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