Individual provider Active NPI

Ken Druyvestein, RPH

  • Pharmacist
  • Polson, MT
National Provider Identifier
1285035451
Registry record updated Sep 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
3449 Issued in MT
Practice address
50331 US Highway 93
Polson, MT 59860-7046
Phone
(406) 883-3838
Fax
(406) 883-3806
NPI assigned
Sep 8, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 3449 MT Primary

Addresses

Primary practice location

50331 US Highway 93
Polson, MT 59860-7046

Mailing address

50331 US Highway 93
Polson, MT 59860-7046
Phone (406) 883-3838

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
3449MTMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1410134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410134400000",
    "number": "1285035451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50331 US HIGHWAY 93",
            "city": "POLSON",
            "state": "MT",
            "postal_code": "598607046",
            "telephone_number": "406-883-3838",
            "fax_number": "406-883-3806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50331 US HIGHWAY 93",
            "city": "POLSON",
            "state": "MT",
            "postal_code": "598607046",
            "telephone_number": "406-883-3838",
            "fax_number": "406-883-3806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRUYVESTEIN",
        "first_name": "KEN",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-09-08",
        "last_updated": "2014-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MT",
            "license": "3449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Polson, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2014; 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.