Healthcare Provider Details

I. General information

NPI: 1932940244
Provider Name (Legal Business Name): PAIN CARE CENTERS - MT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2024
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3490 GABEL RD STE 100
BILLINGS MT
59102-7389
US

IV. Provider business mailing address

2620 COMMERCIAL WAY STE 20
ROCK SPRINGS WY
82901-4705
US

V. Phone/Fax

Practice location:
  • Phone: 307-212-6270
  • Fax: 307-212-6271
Mailing address:
  • Phone: 307-212-6270
  • Fax: 307-212-6271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: RANDAL CHET RUGER
Title or Position: MANAGING PARTNER
Credential:
Phone: 307-267-2116