Provider Demographics
NPI:1306924162
Name:BUNDY MANAGEMENT INC
Entity type:Organization
Organization Name:BUNDY MANAGEMENT INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:VICKEE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:SIEMERS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:406-883-0565
Mailing Address - Street 1:ONE 7TH AVE EAST
Mailing Address - Street 2:
Mailing Address - City:POLSON
Mailing Address - State:MT
Mailing Address - Zip Code:59860
Mailing Address - Country:US
Mailing Address - Phone:406-883-0565
Mailing Address - Fax:406-883-0761
Practice Address - Street 1:ONE 7TH AVE EAST SUITE C
Practice Address - Street 2:
Practice Address - City:POLSON
Practice Address - State:MT
Practice Address - Zip Code:59860
Practice Address - Country:US
Practice Address - Phone:406-883-0565
Practice Address - Fax:406-883-0761
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT11463336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT011002328OtherMEDICARE PTAN
MT214268Medicaid
MT214268Medicaid