CREDENA HEALTH PHARMACY LAKESHORE
NPI 1164809778
Pharmacy - Community/Retail Pharmacy in Polson, MT

Active since May 04, 2015CLIA 27D2314100 · Waiver
50331A US HIGHWAY 93, POLSON, MT 59860(406) 883-0342(406) 883-0469 Get Directions Write a Review

NPPES record last updated: December 7, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Dec 7, 2023, Feb 16, 2023, Jan 21, 2022 and 5 more (8 updates tracked since 2016).

About Credena Health Pharmacy Lakeshore NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CREDENA HEALTH PHARMACY LAKESHORE (NPI 1164809778) is a healthcare organization registered as a community/retail pharmacy in Polson, Montana and active in the NPI registry since May 2015. The organization holds a CLIA Waiver certificate valid through November 12, 2026 and lists Mike Skafi, Avp/secretary, as its authorized official.

NPPES Registry Identity

NPI1164809778
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameCREDENA HEALTH LLC
Location Address50331A US HIGHWAY 93Polson, MT 59860-7046
Mailing AddressPo Box 2704Portland, OR 97208-2704
Fax(406) 883-0469
Organization SubpartNo
Authorized OfficialMike SkafiAvp/secretary · (575) 650-3396
Enumeration DateMay 4, 2015
Last NPPES UpdateDecember 7, 20238 updates tracked since enumeration
NPPES CertifiedDecember 4, 2023
NPI 1164809778 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
Definition

A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

Also ListedPharmacyTaxonomy 333600000X
50331A US HIGHWAY 93, Polson, MT 59860

Other Names 1

Doing Business AsCredena Health Pharmacy Lakeshore

Other Identifiers 1

Other2151758Pk

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 27D2314100

Credena Health Pharmacy Lakeshore · Polson, MT
Active · expires Nov 12, 2026
CLIA Number27D2314100
Laboratory TypePharmacy
Certificate Effective DateNovember 13, 2024
Certificate Expiration DateNovember 12, 2026
Laboratory DirectorKristin Johnson-Doble
Laboratory Phone(406) 883-0342
Laboratory LocationCredena Health Pharmacy Lakeshore50331 Us Hwy 93, Polson, MT 59860
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
36 services35 patients
Influenza vaccine, inactivated 90653
The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.
27 services27 patients

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Credena Health LLC's NPI number?

The NPI number for Credena Health LLC is 1164809778. It was assigned to this organization in the NPPES registry on May 4, 2015. The provider is doing business as Credena Health Pharmacy Lakeshore.

Where is Credena Health LLC located?

Credena Health LLC is located at 50331A Us Highway 93, Polson, MT 59860. The listed phone number is (406) 883-0342.

What is Credena Health LLC's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Does Credena Health LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 27D2314100) is associated with this NPI, valid through November 12, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Credena Health LLC accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 49 other insurers list Credena Health LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Credena Health LLC was last updated on December 7, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.