Haines Medical Pharmacy, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

1064 Issued in MT

Legal business name

HAINES MEDICAL PHARMACY, INC.

Doing business as

Haines Medical Pharmacy

Practice address

1111 Baker Ave
Whitefish, MT 59937-2905

Phone

(406) 862-6301

Fax

(406) 862-6312

NPI assigned

May 11, 2006

Last updated

Mar 7, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Justin S Mackenzie, PHARM. D

Title

Owner/Pharmacy Manager

Phone

(406) 862-6301

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Haines Medical Pharmacy Doing business as

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1639129497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 BAKER AVE",
            "city": "WHITEFISH",
            "state": "MT",
            "postal_code": "599372905",
            "telephone_number": "406-862-6301",
            "fax_number": "406-862-6312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 BAKER AVE",
            "city": "WHITEFISH",
            "state": "MT",
            "postal_code": "599372905",
            "telephone_number": "406-862-6301",
            "fax_number": "406-862-6312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAINES MEDICAL PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-11",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "MACKENZIE",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER/PHARMACY MANAGER",
        "authorized_official_telephone_number": "406-862-6301",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM. D"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MT",
            "license": "1064",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "212772",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MT PHARMACY #",
            "identifier": "1064",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP #",
            "identifier": "2706565",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Haines Medical Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Katie Griffis, LMT
• Megan Groh
• Bronte Grooms, RDN
• Ryan Thomas Gunlikson, M.D.
• Charles Daniel Hagel, PHARMD
• Haines Public Drug, Inc. (Haines Drug)
• Haines Public Drug. Inc
• Carlin Christine Hale, LCPC
• Jordan M Hall, DPT
• Devin R Hallstrom, PT, DPT

• Community/Retail Pharmacy in Whitefish, MT
• Providers in Whitefish, 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 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.