NPIMap

Individual provider Active NPI

Christina Lee Eidem Anderson, PHARMD

  • Pharmacist
  • Missoula, MT
National Provider Identifier
1255763082
Registry record updated Jul 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PHA-PHA-LIC-18611 Issued in MT
Practice address
219 E Main St
Missoula, MT 59802-4423
Phone
(406) 540-5130
NPI assigned
Aug 3, 2013
Last updated
Jul 28, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH60362034 WA
Pharmacist 183500000X PHA-PHA-LIC-18611 MT Primary

Addresses

Primary practice location

219 E Main St
Missoula, MT 59802-4423

Mailing address

219 E Main St
Missoula, MT 59802-4423
Phone (406) 540-5130

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PHA-PHA-LIC-18611MTMDPharmacist
PH60362034WAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Safeway Inc Past Accepting new patients
Safeway Inc Past Accepting new patients

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1375488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595894400000",
    "number": "1255763082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 E MAIN ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024423",
            "telephone_number": "406-540-5130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 E MAIN ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024423",
            "telephone_number": "406-540-5130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "CHRISTINA",
        "middle_name": "LEE EIDEM",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-03",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH60362034",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MT",
            "license": "PHA-PHA-LIC-18611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2020; 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.