Provider Demographics
NPI:1487061578
Name:JBS HOLDINGS LLC
Entity type:Organization
Organization Name:JBS HOLDINGS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:CATHERINE
Authorized Official - Last Name:STILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-862-7434
Mailing Address - Street 1:6475 US HIGHWAY 93 S
Mailing Address - Street 2:
Mailing Address - City:WHITEFISH
Mailing Address - State:MT
Mailing Address - Zip Code:59937-8282
Mailing Address - Country:US
Mailing Address - Phone:406-862-7434
Mailing Address - Fax:406-862-7432
Practice Address - Street 1:6475 US HIGHWAY 93 S
Practice Address - Street 2:
Practice Address - City:WHITEFISH
Practice Address - State:MT
Practice Address - Zip Code:59937-8282
Practice Address - Country:US
Practice Address - Phone:406-862-7434
Practice Address - Fax:406-862-7432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-21
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X, 3336L0003X
MT252273336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2147230OtherPK
MT1487061578Medicaid