Elizabeth Ann Sidebottom, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

7915 Issued in MT

Practice address

5 4TH Ave. East
Polson, MT 59860

Phone

(406) 883-5541

Fax

(406) 883-3512

NPI assigned

Oct 10, 2012

Last updated

Oct 10, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Elizabeth Ann Slagle Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

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

{
    "created_epoch": "1349827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349827200000",
    "number": "1093067449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 880",
            "city": "ST IGNATIUS",
            "state": "MT",
            "postal_code": "59865",
            "telephone_number": "406-745-3525",
            "fax_number": "406-883-3512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 4TH AVE. EAST",
            "city": "POLSON",
            "state": "MT",
            "postal_code": "59860",
            "telephone_number": "406-883-5541",
            "fax_number": "406-883-3512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDEBOTTOM",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-10",
        "last_updated": "2012-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MT",
            "license": "7915",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "43052",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "SLAGLE",
            "middle_name": "ANN",
            "credential": "RPH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Hemlata Shah
• Stephen Andrew Shepro, PA-C
• Thomas E Sherry, M.D.
• Wade Paul Shipley, PA-C
• Kyota Shizuku, PT
• Gayle R. Siemers, D.D.S.
• David J. Sievert, D.D.S.
• Wendy Sitter, PT
• Adam T Smith, D.O.
• Joseph Smith Jr., M.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2012; 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.