Provider Demographics
NPI:1063399343
Name:GASKY, JACK MICHAEL (PHARMD)
Entity type:Individual
Prefix:
First Name:JACK
Middle Name:MICHAEL
Last Name:GASKY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:447 FRANCIS ST
Mailing Address - Street 2:
Mailing Address - City:GLASGOW
Mailing Address - State:MT
Mailing Address - Zip Code:59230-2633
Mailing Address - Country:US
Mailing Address - Phone:315-708-7073
Mailing Address - Fax:
Practice Address - Street 1:54181 US HIGHWAY 2
Practice Address - Street 2:
Practice Address - City:GLASGOW
Practice Address - State:MT
Practice Address - Zip Code:59230-1544
Practice Address - Country:US
Practice Address - Phone:406-228-4701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-19
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTPHA-PHA-LIC-117523183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist