MEDICARE: ALEXANDER RUCKO-SCADUTO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	175T00000X	Peer Specialist	BBH-BHPS-CRT-81513	MT

General Provider Information

NPI Number	:	1295601128
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDER RUCKO-SCADUTO

Provider Business Mailing Address
First Line	:	807 SCENIC DR
Second Line	:
City	:	COLUMBIA FALLS
State	:	MT
Zip	:	59912-4344
Country	:	US
Telephone Number	:	406-857-8091
Fax Number	:

Provider Business Practice Location Address
First Line	:	9549 US ROUTE 2
Second Line	:
City	:	MARTIN CITY
State	:	MT
Zip	:	59926
Country	:	US
Telephone Number	:	406-857-8091
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/16/2025
Last Update Date	:	10/16/2025

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Directions to “ ALEXANDER RUCKO-SCADUTO ” Practice Location

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