Provider Demographics
NPI:1962664292
Name:LEFEVER BOGGS, MICHELE THERESA (PHARMD)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:THERESA
Last Name:LEFEVER BOGGS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:MICHELE
Other - Middle Name:THERESA
Other - Last Name:LEFEVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:419 NUCLEUS AVE
Mailing Address - Street 2:PO BOX 159
Mailing Address - City:COLUMBIA FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59912
Mailing Address - Country:US
Mailing Address - Phone:406-892-9088
Mailing Address - Fax:406-892-9087
Practice Address - Street 1:419 NUCLEUS AVE
Practice Address - Street 2:
Practice Address - City:COLUMBIA FALLS
Practice Address - State:MT
Practice Address - Zip Code:59912-4007
Practice Address - Country:US
Practice Address - Phone:406-892-9088
Practice Address - Fax:406-892-9087
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-27
Last Update Date:2020-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT52581835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist