Active NPI
Deborah Lynne Polk, REGISTERED PHARMACI
- Ambulatory Care Pharmacist
- Missoula, MT
National Provider Identifier
1972105807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Care Pharmacist
- License
- PHA-PHA-LIC-3862
- Practice address
- 500 West Braodway
Missoula, MT 59802 - Phone
- (406) 327-1650
- Fax
- (406) 327-1651
- NPI assigned
- Nov 16, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Care Pharmacist | 1835P2201X | PHA-PHA-LIC-3862 | MT | Primary |
Addresses
Primary practice location
500 West Braodway
Missoula, MT 59802
Mailing address
500 West Braodway
Missoula, MT 59802
Phone (406) 327-1650
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PHA-PHA-LIC-3862 | MT | MD | Ambulatory Care Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605484800000",
"number": "1972105807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 WEST BRAODWAY",
"city": "MISSOULA",
"state": "MT",
"postal_code": "59802",
"telephone_number": "406-327-1650",
"fax_number": "406-327-1651"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 WEST BRAODWAY",
"city": "MISSOULA",
"state": "MT",
"postal_code": "59802",
"telephone_number": "406-327-1650",
"fax_number": "406-327-1651"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLK",
"first_name": "DEBORAH",
"middle_name": "LYNNE",
"name_prefix": "Mrs.",
"credential": "REGISTERED PHARMACI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-16",
"last_updated": "2020-11-16",
"certification_date": "2020-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "1835P2201X",
"taxonomy_group": "",
"desc": "Pharmacist, Ambulatory Care",
"state": "MT",
"license": "PHA-PHA-LIC-3862",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Missoula, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.