Healthcare Provider Details

I. General information

NPI: 1811238603
Provider Name (Legal Business Name): MICHAEL HAGMAN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2013
Last Update Date: 03/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3703 TRAVERTINE WAY
HELENA MT
59602-7411
US

IV. Provider business mailing address

2300 N HARRIS ST BOX 7661
HELENA MT
59604-7035
US

V. Phone/Fax

Practice location:
  • Phone: 406-438-2231
  • Fax: 406-422-0756
Mailing address:
  • Phone: 406-438-2231
  • Fax: 406-422-0756

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL R HAGMAN
Title or Position: OWNER/OPERATOR
Credential: BSN RN
Phone: 406-438-2231