Landmark Specialty Compounding

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

Legal business name

LANDMARK SPECIALTY COMPOUNDING

Practice address

2825 Stockyard Rd Ste A26
Missoula, MT 59808-1547

Phone

(406) 493-6161

NPI assigned

Jun 19, 2021

Last updated

Jun 24, 2021By 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

Kyla Nicole Tripp, PHARMD

Title

Pharmacist

Phone

(406) 545-4656

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1624060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624492800000",
    "number": "1831768373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2825 STOCKYARD RD STE A26",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598081547",
            "telephone_number": "406-545-4656",
            "fax_number": "406-204-5512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 STOCKYARD RD STE A26",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598081547",
            "telephone_number": "406-493-6161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LANDMARK SPECIALTY COMPOUNDING",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-19",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A",
        "authorized_official_last_name": "TRIPP",
        "authorized_official_first_name": "KYLA",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "406-545-4656",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PHA-PHR-LIC-74999",
            "state": "MT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "192.168.1.100",
            "affiliation": "N",
            "endpointDescription": "IPv4",
            "address_1": "2825 Stockyard Rd Ste A26",
            "city": "Missoula",
            "state": "MT",
            "country_code": "US",
            "postal_code": "598081547",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Compounding Pharmacy in Missoula, MT
• Providers in Missoula, MT by specialty
• Compounding Pharmacy in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2021; 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.