Healthcare Provider Details

I. General information

NPI: 1659408326
Provider Name (Legal Business Name): BENEFIS HEALTHCARE PRACTITIONERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 11/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 13TH AVE S SUITE 203
GREAT FALLS MT
59405-4300
US

IV. Provider business mailing address

P.O. BOX 6010
GREAT FALLS MT
59405-5178
US

V. Phone/Fax

Practice location:
  • Phone: 406-727-0590
  • Fax: 406-455-2815
Mailing address:
  • Phone: 406-455-4470
  • Fax: 406-268-0084

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number8796
License Number StateMT

VIII. Authorized Official

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