Plentywood Drug Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

984 Issued in MT

Legal business name

PLENTYWOOD DRUG INC.

Doing business as

Plentywood Rexall Drug

Practice address

119 N Main St
Plentywood, MT 59254-1817

Phone

(406) 765-1810

NPI assigned

Aug 9, 2005

Last updated

Jan 21, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Marvin A Eberling, R.PHNPI 1003837592

Title

Owner

Phone

(406) 765-1810

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• PLENTYWOOD REXALL DRUG Doing business as

Medicare fee-for-service enrollment

Enrolled in MT2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 5

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.

• Marvin A. Eberling, RPH

  • Pharmacist
  • Plentywood, MT
  • NPI 1003837592
  NPD Authorized official
• Kristen Kiemele Berntson, PHARM.D.

  • Pharmacist
  • Plentywood, MT
  • NPI 1164691952
  NPD (past)
• Kathryn M Eberling, RPH

  • Pharmacist
  • Plentywood, MT
  • NPI 1285651935
  NPD (past)
• Robert Conway Mann

  • Pharmacist
  • Plentywood, MT
  • NPI 1568477974
  NPD (past)
• Kirsten Tryan, PHARMD

  • Pharmacist
  • Plentywood, MT
  • NPI 1447825955
  NPD (past)

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453334400000",
    "number": "1073514428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 N MAIN ST",
            "city": "PLENTYWOOD",
            "state": "MT",
            "postal_code": "592541817",
            "telephone_number": "406-765-1810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 N MAIN ST",
            "city": "PLENTYWOOD",
            "state": "MT",
            "postal_code": "592541817",
            "telephone_number": "406-765-1810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLENTYWOOD DRUG INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-09",
        "last_updated": "2016-01-21",
        "status": "A",
        "authorized_official_last_name": "EBERLING",
        "authorized_official_first_name": "MARVIN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "406-765-1810",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MT",
            "license": "984",
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "MT",
            "license": "984",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MT",
            "license": "984",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "MT",
            "license": "984",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "219219",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "1073514428",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PLENTYWOOD REXALL DRUG",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Montana Vamc
• Monte C. Stevens DDS PC (sheridan dental clinic)
• Brit Lindsey Nyby, PA-C
• Sandra Lee Overgaard
• Plentywood Clinic, PC
• Jeff Richardson, LAC
• Sheridan Daniels Special Education Cooperative
• Sheridan Memorial Hospital Association
• Sheridan Memorial Hospital Association
• Sheridan Memorial Hospital Association (Sheridan Memorial DME & Home Oxygen)

• Community/Retail Pharmacy in Plentywood, MT
• Providers in Plentywood, MT by specialty
• Community/Retail Pharmacy in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.