MEDICARE: RURAL INSTITUTE FOR VETERANS EDUCATION AND RESEACH

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251E00000X	Home Health Agency
2	251K00000X	Public Health or Welfare Agency
3	146M00000X	Intermediate Emergency Medical Technician
4	208D00000X	General Practice Physician
5	207PH0002X	Hospice and Palliative Medicine (Emergency Medicine) Physician

General Provider Information

NPI Number	:	1801292669
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RURAL INSTITUTE FOR VETERANS EDUCATION AND RESEACH

Provider Business Mailing Address
First Line	:	217 S EASY ST
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59802-5487
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	217 S EASY ST
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59802-5487
Country	:	US
Telephone Number	:	406-540-2302
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	ED LESOFSKI
Credential	:
Telephone Number	:	406-540-2302

Provider Enumeration Date	:	11/06/2014
Last Update Date	:	11/06/2014

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