NPI 1255329710

Jack Tidaback, RPH

Practitioner Pharmacist Sidney, MT

Practice location

Address: 214 14th Ave SW, Sidney, MT 59270-3521
Phone: (406) 488-6563
Fax: (406) 488-2231

Registered specialties

Pharmacist Primary

Pharmacy Service Providers Taxonomy 183500000X Licence 3118 (MT)

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Registry record

NPI: 1255329710
Entity type: Individual
Sex (as registered): Male
NPI issued: 10 Oct 2005
Record last updated: 13 Jul 2026

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.