Samantha Anne Basco, PHARMD
Individual provider Active NPI Pharmacist · Great Falls, MT
NPI 1043861669 · NPPES record last updated Sep 25, 2019
Key facts
- NPI
- 1043861669
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- PHA-PHA-LIC-62925 (MT)
- Practice address
- 1101 26TH St S
Great Falls, MT 59405-5161 - Phone
- (406) 455-5430
- NPI assigned
- Sep 25, 2019
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PHA-PHA-LIC-62925 | MT | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PHA-PHA-LIC-62925 | MT | Yes |
Addresses
Primary practice location
1101 26TH St S
Great Falls, MT 59405-5161
Mailing address
2102 26TH St S Unit 205
Great Falls, MT 59405-5158
Phone (912) 596-1268
Other providers in Great Falls, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 25, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.