MEDICARE: MONTANA HOME HEALTH SUPPLIES

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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1801005558
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MONTANA HOME HEALTH SUPPLIES

Provider Business Mailing Address
First Line	:	439 1ST RD S
Second Line	:
City	:	FORT SHAW
State	:	MT
Zip	:	59443-9528
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	439 1ST RD S
Second Line	:
City	:	FORT SHAW
State	:	MT
Zip	:	59443-9528
Country	:	US
Telephone Number	:	406-899-0900
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SANDRA ODEGARD
Credential	:
Telephone Number	:	406-899-0900

Provider Enumeration Date	:	05/21/2007
Last Update Date	:	07/08/2008

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