Healthcare Provider Details

I. General information

NPI: 1659435352
Provider Name (Legal Business Name): ROCKY MOUNTAIN MEDICAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 01/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2110 OVERLAND AVE SUITE 112
BILLINGS MT
59102-6480
US

IV. Provider business mailing address

PO BOX 30215
BILLINGS MT
59107-0215
US

V. Phone/Fax

Practice location:
  • Phone: 406-294-0794
  • Fax:
Mailing address:
  • Phone: 406-294-0794
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW ROBERT WARNICK
Title or Position: MANAGER
Credential:
Phone: 406-294-0794