Jaqueth, Fredrick Thomas

Jaqueth, Fredrick Thomas is an sole proprietor health care provider with primary practice located at 906 Montana Ave , Libby MT 59923-2014. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Jaqueth, Fredrick Thomas can be contacted via phone (406) 293-3958.

Contact Information

Primary practice address
906 Montana Ave Libby MT 59923-2014
Phone: (406) 293-3958
Fax: (406) 293-5858
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X 884 Montana

Profile Details

NPI number 1093853335
LBN Legal business name Jaqueth, Fredrick Thomas
Credentials RPH
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 1st, 2007
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093853335 NPPES
Montana MEDICAID 0220201

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