Healthcare Provider Details

I. General information

NPI: 1013152727
Provider Name (Legal Business Name): BENEFIS HEALTHCARE PRACTITIONERS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2008
Last Update Date: 12/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1117 29TH ST S
GREAT FALLS MT
59405-5306
US

IV. Provider business mailing address

2519 13TH AVE S
GREAT FALLS MT
59405-5178
US

V. Phone/Fax

Practice location:
  • Phone: 406-731-8150
  • Fax: 406-731-8178
Mailing address:
  • Phone: 406-455-4470
  • Fax: 406-268-0084

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number7270
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number11840
License Number StateMT

VIII. Authorized Official

Name: DANIEL J REINER
Title or Position: CHIEF ADMINISTRATIVE OFFICER
Credential:
Phone: 406-455-4470