Active NPI
Timber Ridge Pharmacy
- Long Term Care Pharmacy
- Hamilton, MT
National Provider Identifier
1003841016
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Long Term Care Pharmacy
- License
- 1097
- Legal business name
- TIMBER RIDGE PHARMACY
- Practice address
- 1131 N 1St St
Hamilton, MT 59840-2150 - Phone
- (406) 363-9003
- Fax
- (406) 363-9005
- NPI assigned
- Jul 11, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Lans Richardson IV
- Title
- Owner/Pharmacy Tech
- Phone
- (406) 363-9003
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Long Term Care Pharmacy | 3336L0003X | 1097 | MT | Primary |
Addresses
Primary practice location
1131 N 1St St
Hamilton, MT 59840-2150
Mailing address
1131 N 1St St
Hamilton, MT 59840-2150
Phone (406) 363-9003
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5607030 | Medicaid | MT | |
| 0213408 | Medicaid | MT |
National Provider Directory
National Provider Directory- Tax ID family
- Timber Ridge Pharmacy
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Community/Retail Pharmacy
- Hamilton, MT
- NPI 1902836927
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152576000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1705017600000",
"number": "1003841016",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1131 N 1ST ST",
"city": "HAMILTON",
"state": "MT",
"postal_code": "598402150",
"telephone_number": "406-363-9003",
"fax_number": "406-363-9005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1131 N 1ST ST",
"city": "HAMILTON",
"state": "MT",
"postal_code": "598402150",
"telephone_number": "406-363-9003",
"fax_number": "406-363-9005"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TIMBER RIDGE PHARMACY",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-11",
"last_updated": "2024-01-12",
"certification_date": "2024-01-12",
"status": "A",
"authorized_official_last_name": "RICHARDSON",
"authorized_official_first_name": "LANS",
"authorized_official_title_or_position": "OWNER/PHARMACY TECH",
"authorized_official_telephone_number": "406-363-9003",
"authorized_official_name_suffix": "IV"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336L0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Long Term Care Pharmacy",
"state": "MT",
"license": "1097",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5607030",
"state": "MT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0213408",
"state": "MT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Hamilton, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.