Provider Demographics
NPI:1366449589
Name:CITRON, ROGER ARTHUR (RPH)
Entity type:Individual
Prefix:MR
First Name:ROGER
Middle Name:ARTHUR
Last Name:CITRON
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1400 E BROADWAY ST
Mailing Address - Street 2:A-206
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-5231
Mailing Address - Country:US
Mailing Address - Phone:406-444-5951
Mailing Address - Fax:406-444-1861
Practice Address - Street 1:1400 E BROADWAY ST
Practice Address - Street 2:A-206
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-5231
Practice Address - Country:US
Practice Address - Phone:406-444-5951
Practice Address - Fax:406-444-1861
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT3729183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist