Provider Demographics
NPI:1730350018
Name:SILVERTIP PHARMACY INC
Entity type:Organization
Organization Name:SILVERTIP PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CLIFFORD
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:406-646-7056
Mailing Address - Street 1:PO BOX 30
Mailing Address - Street 2:
Mailing Address - City:WEST YELLOWSTONE
Mailing Address - State:MT
Mailing Address - Zip Code:59758-0030
Mailing Address - Country:US
Mailing Address - Phone:406-431-1172
Mailing Address - Fax:
Practice Address - Street 1:120 N CANYON ST
Practice Address - Street 2:STE F
Practice Address - City:WEST YELLOWSTONE
Practice Address - State:MT
Practice Address - Zip Code:59758-9500
Practice Address - Country:US
Practice Address - Phone:406-646-7056
Practice Address - Fax:406-646-7058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-14
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X
MT12503336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2052661OtherPK