NPIMap

Organization Active NPI

Bozeman Health Deaconess Hospital

Doing business as Highland Park Pharmacy

  • Community/Retail Pharmacy
  • Bozeman, MT
National Provider Identifier
1740387661
Registry record updated Mar 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
664 Issued in MT
Legal business name
BOZEMAN HEALTH DEACONESS HOSPITAL
Doing business as
Highland Park Pharmacy
Practice address
925 Highland Blvd
Suite 2000
Bozeman, MT 59715-6900
Phone
(406) 414-1030
Fax
(406) 414-5096
NPI assigned
Sep 20, 2006
Last updated
Mar 15, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2022

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

Authorized official

Name
Alan Brayton, RPH PHARMDNPI 1316991409
Title
Clinical Pharmacist Supervisor
Phone
(406) 585-5030

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 664 MT Primary
Institutional Pharmacy 3336I0012X
Specialty Pharmacy 3336S0011X
Compounding Pharmacy 3336C0004X

Addresses

Primary practice location

925 Highland Blvd
Suite 2000
Bozeman, MT 59715-6900

Mailing address

925 Highland Blvd
Bozeman, MT 59715-6900
Phone (406) 414-1030

Other identifiers 2

IdentifierTypeStateIssuer
2050311OtherPK
000213434MedicaidMT

Other names 1

  • HIGHLAND PARK PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20220419002120 MT Part B Supplier - Pharmacy 4688984164 Practice locations: Bozeman, MT
O20220610002102 MT DME Supplier - Pharmacy 4688984164 Practice locations: Bozeman, MT

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

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

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Highland Park Pharmacy925 Highland Blvd, Bozeman, MT 59715-6906(406) 414-1030 Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since May 24, 2018

National Provider Directory

National Provider Directory
Tax ID family
Bozeman Health Deaconess Hospital9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

925 Highland Blvd
Bozeman, MT 59715
Phone (406) 414-3780

Practitioners & affiliated clinicians

Practitioners 3

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": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647302400000",
    "number": "1740387661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 HIGHLAND BLVD",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597156900",
            "telephone_number": "406-414-1030",
            "fax_number": "406-414-5096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 HIGHLAND BLVD",
            "address_2": "SUITE 2000",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597156900",
            "telephone_number": "406-414-1030",
            "fax_number": "406-414-5096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOZEMAN HEALTH DEACONESS HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2022-03-15",
        "certification_date": "2022-03-15",
        "status": "A",
        "authorized_official_last_name": "BRAYTON",
        "authorized_official_first_name": "ALAN",
        "authorized_official_title_or_position": "CLINICAL PHARMACIST SUPERVISOR",
        "authorized_official_telephone_number": "406-585-5030",
        "authorized_official_credential": "RPH PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MT",
            "license": "664",
            "primary": true
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2050311",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000213434",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HIGHLAND PARK PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "HIGHLAND PARK PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bozeman, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2022; 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.