Provider Demographics
NPI:1427102334
Name:FROST, AMY ANN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:ANN
Last Name:FROST
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 STEVENSVILLE CUTOFF RD
Mailing Address - Street 2:
Mailing Address - City:STEVENSVILLE
Mailing Address - State:MT
Mailing Address - Zip Code:59870-6496
Mailing Address - Country:US
Mailing Address - Phone:406-777-3446
Mailing Address - Fax:406-777-4192
Practice Address - Street 1:39 STEVENSVILLE CUTOFF RD
Practice Address - Street 2:
Practice Address - City:STEVENSVILLE
Practice Address - State:MT
Practice Address - Zip Code:59870-6496
Practice Address - Country:US
Practice Address - Phone:406-777-3446
Practice Address - Fax:406-777-4192
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT5245183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0210460Medicaid
MT1230190001Medicare ID - Type Unspecified