Provider Demographics
NPI:1972697779
Name:BGC INCORPORATED
Entity type:Organization
Organization Name:BGC INCORPORATED
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:SHEAR
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:406-827-4349
Mailing Address - Street 1:1221 MAIN STREET
Mailing Address - Street 2:PO BOX 1028
Mailing Address - City:THOMPSON FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59873-1028
Mailing Address - Country:US
Mailing Address - Phone:406-827-4349
Mailing Address - Fax:406-827-9640
Practice Address - Street 1:1221 MAIN ST.
Practice Address - Street 2:
Practice Address - City:THOMPSON FALLS
Practice Address - State:MT
Practice Address - Zip Code:59873-1028
Practice Address - Country:US
Practice Address - Phone:406-827-4349
Practice Address - Fax:406-827-9640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT10953336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT021-5111Medicaid
MT021-5111Medicaid