Healthcare Provider Details

I. General information

NPI: 1720031412
Provider Name (Legal Business Name): KALISPELL REGIONAL MEDICAL CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 04/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 OSLOSKI RD
EUREKA MT
59917-9217
US

IV. Provider business mailing address

PO BOX 2069
EUREKA MT
59917-2069
US

V. Phone/Fax

Practice location:
  • Phone: 406-297-3145
  • Fax: 406-297-3364
Mailing address:
  • Phone: 406-297-3145
  • Fax: 406-297-7023

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: VELINDA J STEVENS
Title or Position: CEO/PRESIDENT
Credential:
Phone: 406-752-1724