Provider Demographics
NPI:1376022764
Name:BROOKER, MICHAEL LEE (PHARMD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:LEE
Last Name:BROOKER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 E 3RD AVE N
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:MT
Mailing Address - Zip Code:59019-7122
Mailing Address - Country:US
Mailing Address - Phone:406-396-8340
Mailing Address - Fax:
Practice Address - Street 1:511 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-5813
Practice Address - Country:US
Practice Address - Phone:406-245-4301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-07
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT59751835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care