Active NPI
Pole Mountain Pharmacy LLC
Doing business as Pole Mountain Pharmacy LTC
- Long Term Care Pharmacy
- Laramie, WY
National Provider Identifier
1700708203
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Long Term Care Pharmacy
- Legal business name
- POLE MOUNTAIN PHARMACY LLC
- Doing business as
- Pole Mountain Pharmacy LTC
- Practice address
- 319 E Harney St
Laramie, WY 82072-2523 - Phone
- (307) 460-4080
- Fax
- (307) 460-4082
- NPI assigned
- Jul 27, 2026
- Last updated
- Jul 27, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Brett Kvenild, RPH
- Title
- Member
- Phone
- (307) 460-4080
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Long Term Care Pharmacy | 3336L0003X | Primary |
Addresses
Primary practice location
319 E Harney St
Laramie, WY 82072-2523
Mailing address
319 E Harney St
Laramie, WY 82072-2523
Phone (307) 460-4080
Other names 1
- Pole Mountain Pharmacy LTC
National Provider Directory
National Provider Directory- Tax ID family
- Pole Mountain Pharmacy
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Pole Mountain Pharmacy
- Community/Retail Pharmacy
- Laramie, WY
- NPI 1013422971
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1785110400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1785110400000",
"number": "1700708203",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "319 E HARNEY ST",
"city": "LARAMIE",
"state": "WY",
"postal_code": "820722523",
"telephone_number": "307-460-4080",
"fax_number": "307-460-4082"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "319 E HARNEY ST",
"city": "LARAMIE",
"state": "WY",
"postal_code": "820722523",
"telephone_number": "307-460-4080",
"fax_number": "307-460-4082"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "POLE MOUNTAIN PHARMACY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-07-27",
"last_updated": "2026-07-27",
"certification_date": "2026-07-27",
"status": "A",
"authorized_official_last_name": "KVENILD",
"authorized_official_first_name": "BRETT",
"authorized_official_title_or_position": "MEMBER",
"authorized_official_telephone_number": "307-460-4080",
"authorized_official_credential": "RPH"
},
"taxonomies": [
{
"code": "3336L0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Long Term Care Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Pole Mountain Pharmacy LTC",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Laramie, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.