Aleesha Porter, RPH

Individual provider Active NPI Pharmacist · Laurel, MT

NPI 1811517204 · NPPES record last updated Apr 26, 2020

Key facts

NPI
1811517204
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
PHA-PHA-LIC-63043 (MT)
Practice address
307 SE 4TH St
Laurel, MT 59044-3324
Phone
(406) 628-8746
NPI assigned
Apr 26, 2020
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
PHA-PHA-LIC-63043MTMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PHA-PHA-LIC-63043 MT Yes

Addresses

Primary practice location

307 SE 4TH St
Laurel, MT 59044-3324

Mailing address

307 SE 4TH St
Laurel, MT 59044-3324
Phone (406) 628-8746

Other providers in Laurel, MT

All providers in Laurel, MT · Pharmacist in Montana

Sources for this page

Verify at the official NPI Registry.