NPIMap

Organization Active NPI

Northeast Montana Health Services Inc

Doing business as Poplar Pharmacy

  • Community/Retail Pharmacy
  • Poplar, MT
National Provider Identifier
1811147192
Registry record updated Nov 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
1266 Issued in MT
Legal business name
NORTHEAST MONTANA HEALTH SERVICES INC
Doing business as
Poplar Pharmacy
Practice address
213 H St
Poplar, MT 59255-9519
Phone
(406) 768-6147
Fax
(406) 768-6187
NPI assigned
Sep 24, 2008
Reactivated
May 31, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2023

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

Authorized official

Name
Mr. Richard Ray Baland, CPA
Title
Cfo
Phone
(512) 484-4850

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 1266 MT Primary
Long Term Care Pharmacy 3336L0003X

Addresses

Primary practice location

213 H St
Poplar, MT 59255-9519

Mailing address

211 H St
Poplar, MT 59255-9519
Phone (406) 768-6147

Other identifiers 2

IdentifierTypeStateIssuer
2117106OtherPK
1811147192MedicaidMT

Other names 1

  • POPLAR PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Poplar Comm Hosp4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1222214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699142400000",
    "number": "1811147192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 H ST",
            "city": "POPLAR",
            "state": "MT",
            "postal_code": "592559519",
            "telephone_number": "406-768-6147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 H ST",
            "city": "POPLAR",
            "state": "MT",
            "postal_code": "592559519",
            "telephone_number": "406-768-6147",
            "fax_number": "406-768-6187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST MONTANA HEALTH SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-24",
        "last_updated": "2023-11-05",
        "certification_date": "2023-11-05",
        "deactivation_date": "2018-05-16",
        "reactivation_date": "2018-05-31",
        "status": "A",
        "authorized_official_last_name": "BALAND",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "512-484-4850",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPA"
    },
    "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": "1266",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2117106",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1811147192",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "POPLAR PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Poplar, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.