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NPI Code Detail

MEDICARE: MONTANA LITHOTRIPSY,LLC

MEDICARE: MONTANA LITHOTRIPSY,LLC
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
1335V00000XPortable X-ray and/or Other Portable Diagnostic Imaging Supplier

General Provider Information

NPI Number : 1326242934
Entity Type Code : Organization
Provider Name (Legal Business Name) : MONTANA LITHOTRIPSY,LLC
Provider Business Mailing Address
First Line : 630 W MERCURY ST
Second Line :
City : BUTTE
State : MT
Zip : 59701-1510
Country : US
Telephone Number : 406-723-7000
Fax Number : 406-723-7004
Provider Business Practice Location Address
First Line : 630 W MERCURY ST
Second Line :
City : BUTTE
State : MT
Zip : 59701-1510
Country : US
Telephone Number : 406-723-7000
Fax Number : 406-723-7004
Authorized Official
Title or Position : OWNER
Name : DR. MICHAEL ERVIN KUGLITSCH
Credential : MD
Telephone Number : 406-723-7000
Provider Enumeration Date : 06/14/2007
Last Update Date : 08/22/2020

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Directions to “MONTANA LITHOTRIPSY,LLC ” Practice Location

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