Healthcare Provider Details

I. General information

NPI: 1477989770
Provider Name (Legal Business Name): KALISPELL REGIONAL MEDICAL CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2013
Last Update Date: 04/29/2024
Certification Date: 04/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 SUNNYVIEW LN
KALISPELL MT
59901-3129
US

IV. Provider business mailing address

310 SUNNYVIEW LN
KALISPELL MT
59901-3129
US

V. Phone/Fax

Practice location:
  • Phone: 406-751-6725
  • Fax:
Mailing address:
  • Phone: 406-751-6725
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number11047
License Number StateMT

VIII. Authorized Official

Name: KEVIN ABEL
Title or Position: PRESIDENT
Credential:
Phone: 406-752-1724