Mineral Drug, Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

MINERAL DRUG, INC

Doing business as

Mineral Pharmacy

Practice address

207 River St
Superior, MT 59872-9673

Phone

(406) 822-4681

Fax

(406) 822-0057

NPI assigned

Apr 28, 2021

Organization subpart

No

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

Authorized official

Name

Andrea R Holmes, RPHNPI 1386086452

Title

President/Pharmacist

Phone

(406) 822-4681

Specialties & licenses 3

Addresses

Other names 1

• Mineral Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in MT2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare medical equipment & supply locations

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Andrea Ruth Holmes, RPH

  • Pharmacist
  • Plains, MT
  • NPI 1386086452
  NPD Authorized official
• Brayden Michael Leake, PHARM.D.

  • Pharmacist
  • Superior, MT
  • NPI 1336016971
  NPD (past)
• Mason Luce

  • Pharmacist
  • Plains, MT
  • NPI 1326912775
  NPD (past)

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

{
    "created_epoch": "1619568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631750400000",
    "number": "1629651690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1407",
            "city": "PLAINS",
            "state": "MT",
            "postal_code": "598591407",
            "telephone_number": "406-822-4681",
            "fax_number": "406-822-0057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 RIVER ST",
            "city": "SUPERIOR",
            "state": "MT",
            "postal_code": "598729673",
            "telephone_number": "406-822-4681",
            "fax_number": "406-822-0057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINERAL DRUG, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-28",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A",
        "authorized_official_last_name": "HOLMES",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT/PHARMACIST",
        "authorized_official_telephone_number": "406-822-4681",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mineral Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mineral Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Masc LLC
• Linea Maxwell, LCSW
• Stewart Andrew McCracken, LAC
• Lawana V McGuffey, ACLC, SWLC, MSW
• Jenny Lynn Miller, LAC-BBH-LAC-LIC-4969
• Mineral Pharmacy Inc
• Mineral Regional Health Center Inc.
• Missoula Community Health Services, Inc (Mineral Community Hospital Clinic)
• Missoula Community Health Services, Inc (Tamarack Medical Clinic)
• Missoula Community Health Services, Inc (Mineral Community Hospital)

• Community/Retail Pharmacy in Superior, MT
• Providers in Superior, MT by specialty
• Community/Retail Pharmacy in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.