Provider Demographics
NPI:1598596207
Name:LONG, JAMIE (PHARMD)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:LONG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:
Other - Last Name:VASHUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:214 N 28TH ST
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-1935
Mailing Address - Country:US
Mailing Address - Phone:406-206-2001
Mailing Address - Fax:406-206-1972
Practice Address - Street 1:214 N 28TH ST
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-1935
Practice Address - Country:US
Practice Address - Phone:406-206-2001
Practice Address - Fax:406-206-1972
Is Sole Proprietor?:No
Enumeration Date:2024-08-13
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTPHA-PHA-LIC-4843183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist