Renee Wilkonski-Larson

Primary specialty

PharmacistTaxonomy code 183500000X

License

3744 Issued in MT

Practice address

55 1St Ave En
Kalispell, MT 59901-4001

Phone

(406) 370-9877

NPI assigned

Dec 13, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Glacier Ridge Pharmacy Inc

  dba Glacier Ridge Pharmacy

  • Community/Retail Pharmacy
  • Kalispell, MT
  • NPI 1205062098
  NPD (past) Authorized official
• Glacier Ridge Pharmacy Inc

  dba Alpine Ridge Pharmacy

  • Community/Retail Pharmacy
  • Whitefish, MT
  • NPI 1659504363
  NPD (past) Authorized official

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

{
    "created_epoch": "1386892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386892800000",
    "number": "1033530290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7543",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599040543",
            "telephone_number": "406-370-9877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 1ST AVE EN",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599014001",
            "telephone_number": "406-370-9877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKONSKI-LARSON",
        "first_name": "RENEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-13",
        "last_updated": "2013-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MT",
            "license": "3744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erika Wilcox
• Wallace S Wilder, M.D.
• Wilkes Speech Therapy, PLLC
• Sheridan Wilkes, M.S., CCC-SLP
• Neal W Wilkinson, MD
• Amy B Willcoxon, PSYD
• John L Willcut, NP
• Alan B Williams, M.D.
• Allison Taylor Williams, SWLC, MSW
• Jason Williams, RPH

• Pharmacist in Kalispell, MT
• Providers in Kalispell, MT by specialty
• Pharmacist in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.