NPIMap

Organization Active NPI

Billings Clinic Specialty Supplies and Services, LLC

Doing business as Billings Clinic Specialty Pharmacy

  • Community/Retail Pharmacy
  • Billings, MT
National Provider Identifier
1326564857
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHA-PHR-LIC-47172 Issued in MT
Legal business name
BILLINGS CLINIC SPECIALTY SUPPLIES AND SERVICES, LLC
Doing business as
Billings Clinic Specialty Pharmacy
Practice address
1015 Broadwater Ave Ste 101
Billings, MT 59102
Phone
(406) 657-4545
Fax
(406) 435-6393
NPI assigned
Aug 16, 2017
Last updated
Jun 16, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
BILLINGS CLINIC SPECIALTY SUPPLIES AND SERVICES, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Authorized official

Name
Connie Prewitt
Title
Vice President, Chief Financial Off
Phone
(406) 657-4546

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PHA-PHR-LIC-47172 MT Primary

Addresses

Primary practice location

1015 Broadwater Ave Ste 101
Billings, MT 59102

Mailing address

1015 Broadwater Ave Ste 101
Billings, MT 59102-5446

Other identifiers 1

IdentifierTypeStateIssuer
PHA-PHR-LIC-47172OtherMTSTATE OF MONTANA BOARD OF PHARMACY

Other names 2

  • Billings Clinic Specialty Pharmacy Doing business as
  • Billings Clinic Specialty Supplies Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180717003622 MT DME Supplier - Pharmacy 2567723521 Practice locations: Billings, 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
Part of
Billings Clinic Specialty

Locations

1015 Broadwater Ave
Ste 101
Billings, MT 59102
Phone (406) 657-4545

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 4

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": "1502841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1326564857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 BROADWATER AVE STE 101",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591025446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 BROADWATER AVE STE 101",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "59102",
            "telephone_number": "406-657-4545",
            "fax_number": "406-435-6393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BILLINGS CLINIC SPECIALTY SUPPLIES AND SERVICES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BILLINGS CLINIC SPECIALTY SUPPLIES AND SERVICES, LLC",
        "enumeration_date": "2017-08-16",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "PREWITT",
        "authorized_official_first_name": "CONNIE",
        "authorized_official_title_or_position": "VICE PRESIDENT, CHIEF FINANCIAL OFF",
        "authorized_official_telephone_number": "406-657-4546"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MT",
            "license": "PHA-PHR-LIC-47172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MONTANA BOARD OF PHARMACY",
            "identifier": "PHA-PHR-LIC-47172",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Billings Clinic Specialty Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Billings Clinic Specialty Supplies",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Billings, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.