Healthcare Provider Details

I. General information

NPI: 1902092489
Provider Name (Legal Business Name): ROCKY MOUNTAIN SLEEP DISORDERS CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2007
Last Update Date: 12/11/2020
Certification Date: 12/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1917 4TH ST S
GREAT FALLS MT
59405-4149
US

IV. Provider business mailing address

1917 4TH ST S
GREAT FALLS MT
59405-4149
US

V. Phone/Fax

Practice location:
  • Phone: 406-453-7570
  • Fax:
Mailing address:
  • Phone: 406-453-7570
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PAUL F SCHMOOK
Title or Position: CEO
Credential: RPSGT
Phone: 406-453-7570