NPIMap

Organization Active NPI

Pharmfill Inc

Doing business as Remedies Lakeside

  • Community/Retail Pharmacy
  • Lakeside, MT
National Provider Identifier
1013265917
Registry record updated Aug 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
28638 Issued in MT
Legal business name
PHARMFILL INC
Doing business as
Remedies Lakeside
Practice address
206 Stoner Loop
Lakeside, MT 59922-9540
Phone
(406) 844-2103
Fax
(406) 844-2106
NPI assigned
Aug 27, 2012
Last updated
Aug 11, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Justin Vancampen
Title
Owner
Phone
(406) 844-2103

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 28638 MT Primary
Long Term Care Pharmacy 3336L0003X
Compounding Pharmacy 3336C0004X

Addresses

Primary practice location

206 Stoner Loop
Lakeside, MT 59922-9540

Mailing address

206 Stoner Loop Rd
Lakeside, MT 59922-9540
Phone (406) 844-2103

Other identifiers 1

IdentifierTypeStateIssuer
2136466OtherPK

Other names 1

  • Remedies Lakeside Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140130001851 MT Part B Supplier - Mass Immunization (Roster Biller Only) 0941400832 Practice locations: Chester, MT; Lakeside, MT; Harlowton, MT

National Provider Directory

National Provider Directory
Tax ID family
Pharmfill Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

206 Stoner Loop
Lakeside, MT 59922
Phone (406) 844-2103

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1346025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439251200000",
    "number": "1013265917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 STONER LOOP RD",
            "city": "LAKESIDE",
            "state": "MT",
            "postal_code": "599229540",
            "telephone_number": "406-844-2103",
            "fax_number": "406-844-2106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 STONER LOOP",
            "city": "LAKESIDE",
            "state": "MT",
            "postal_code": "599229540",
            "telephone_number": "406-844-2103",
            "fax_number": "406-844-2106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHARMFILL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-27",
        "last_updated": "2015-08-11",
        "status": "A",
        "authorized_official_last_name": "VANCAMPEN",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "406-844-2103"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MT",
            "license": "28638",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2136466",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Remedies Lakeside",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lakeside, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.