Provider Demographics
NPI:1124328448
Name:TOMICH, MAUREEN (RPH)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:
Last Name:TOMICH
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 MASSACHUETTS AVE
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701
Mailing Address - Country:US
Mailing Address - Phone:406-494-3754
Mailing Address - Fax:406-494-3823
Practice Address - Street 1:2500 MASSACHUETTS AVE
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701
Practice Address - Country:US
Practice Address - Phone:406-494-3754
Practice Address - Fax:406-494-3823
Is Sole Proprietor?:No
Enumeration Date:2010-11-03
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT3714183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist