Keystone Drug LLP

Primary specialty

PharmacistTaxonomy code 183500000X

License

776 Issued in MT

Legal business name

KEYSTONE DRUG LLP

Practice address

407 Main St
Deer Lodge, MT 59722-1058

Phone

(406) 846-2120

Fax

(406) 846-2348

NPI assigned

Oct 5, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Jack M Andersen, R.PH.

Title

Owner/ Pharmacist

Phone

(406) 846-2120

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1487741245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 MAIN ST",
            "city": "DEER LODGE",
            "state": "MT",
            "postal_code": "597221058",
            "telephone_number": "406-846-2120",
            "fax_number": "406-846-2348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 MAIN ST",
            "city": "DEER LODGE",
            "state": "MT",
            "postal_code": "597221058",
            "telephone_number": "406-846-2120",
            "fax_number": "406-846-2348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYSTONE DRUG LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "ANDERSEN",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/ PHARMACIST",
        "authorized_official_telephone_number": "406-846-2120",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "MT",
            "license": "776",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "220714",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP #",
            "identifier": "2700878",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Harris Home Care LLC
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• Dawn Heiydt
• Michelle K Howard, M.D.
• Ivy at Deer Lodge LLC
• Tristan E Kohut, DO
• Patrick Joseph Krach, MD
• Patricia J Lacey, RPH
• Leonard & David Vainio PC
• Hailie Nicole Maas, PMHNP-BC DNP

• All providers in Deer Lodge, MT
• Pharmacist in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.