Organization Active NPI

Superior Specialty Pharmacy of Montana, LLC

  • General Practice Physician
  • Helena, MT
National Provider Identifier
1285517268
Registry record updated Apr 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
SUPERIOR SPECIALTY PHARMACY OF MONTANA, LLC
Practice address
630 N Last Chance Gulch
Ste 1100 Room 1111
Helena, MT 59601-3551
Phone
(406) 752-0440
NPI assigned
Jul 28, 2025
Last updated
Apr 21, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2026

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

Authorized official

Name
Heather Peacock, VANPI 1376845362
Title
General Manager
Phone
(406) 752-0440

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Infusion Therapy Clinic/Center 261QI0500X NU
General Practice Physician 208D00000X NU Primary
Home Infusion Therapy Pharmacy 3336H0001X NU

Addresses

Primary practice location

630 N Last Chance Gulch
Ste 1100 Room 1111
Helena, MT 59601-3551

Mailing address

630 N Last Chance Gulch Ste 1100
Ste 1100 Room 1111
Helena, MT 59601-3551

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250930002897 MT Part B Supplier - Clinic/Group Practice 8628279635 Receives reassigned benefits from 2 practitioners
Practice locations: Helena, MT; Kalispell, MT

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Superior Specialty Pharmacy of Montana LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

630 N Last Chance Gulch
Helena, MT 59601
Phone (406) 442-8508

630 N Last Chance Gulch
Ste 1100
Helena, MT 59601
Phone (406) 646-2522

20 Four Mile Dr
Ste 3
Kalispell, MT 59901
Phone (406) 752-0440

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1753660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776729600000",
    "number": "1285517268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 N LAST CHANCE GULCH STE 1100",
            "address_2": "STE 1100 ROOM 1111",
            "city": "HELENA",
            "state": "MT",
            "postal_code": "596013551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 N LAST CHANCE GULCH",
            "address_2": "STE 1100 ROOM 1111",
            "city": "HELENA",
            "state": "MT",
            "postal_code": "596013551",
            "telephone_number": "406-752-0440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPERIOR SPECIALTY PHARMACY OF MONTANA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-28",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A",
        "authorized_official_last_name": "PEACOCK",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "406-752-0440",
        "authorized_official_credential": "VA"
    },
    "taxonomies": [
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Helena, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.