NPIMap

Organization Active NPI

KCS Western Drug Inc

  • Community/Retail Pharmacy
  • Gardiner, MT
National Provider Identifier
1285791590
Registry record updated Dec 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHA-PHR-LIC-27961 Issued in MT
Legal business name
KCS WESTERN DRUG INC
Practice address
318 Park St
Gardiner, MT 59030-7735
Phone
(406) 848-9430
Fax
(406) 848-9465
NPI assigned
Jan 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2020

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

Authorized official

Name
Kari Vondra
Title
Owner
Phone
(406) 222-7332

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PHA-PHR-LIC-27961 MT Primary

Addresses

Primary practice location

318 Park St
Gardiner, MT 59030-7735

Mailing address

PO Box 67
Gardiner, MT 59030-0067
Phone (406) 848-9430

Other identifiers 1

IdentifierTypeStateIssuer
1235534561MedicaidMT

Other names 1

  • GARDINER PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Gardiner Pharmacy5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

318 Park St
Gardiner, MT 59030
Phone (406) 848-9430

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607644800000",
    "number": "1285791590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 67",
            "city": "GARDINER",
            "state": "MT",
            "postal_code": "590300067",
            "telephone_number": "406-848-9430",
            "fax_number": "406-848-9465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 PARK ST",
            "city": "GARDINER",
            "state": "MT",
            "postal_code": "590307735",
            "telephone_number": "406-848-9430",
            "fax_number": "406-848-9465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KCS WESTERN DRUG INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A",
        "authorized_official_last_name": "VONDRA",
        "authorized_official_first_name": "KARI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "406-222-7332"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MT",
            "license": "PHA-PHR-LIC-27961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1235534561",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GARDINER PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "GARDINER PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gardiner, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 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.