Healthcare Provider Details
I. General information
NPI: 1154785822
Provider Name (Legal Business Name): KALISPELL REGIONAL MEDICAL CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/08/2016
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
202 CONWAY DR STE 200
KALISPELL MT
59901-3153
US
IV. Provider business mailing address
202 CONWAY DR STE 200
KALISPELL MT
59901-3153
US
V. Phone/Fax
- Phone: 844-215-7969
- Fax:
- Phone: 844-215-7969
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 40780 |
| License Number State | MT |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2080P0202X |
| Taxonomy | Pediatric Cardiology Physician |
| License Number | 40780 |
| License Number State | MT |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2080P0206X |
| Taxonomy | Pediatric Gastroenterology Physician |
| License Number | 18743 |
| License Number State | MT |
VIII. Authorized Official
Name:
JOSH
NEFF
Title or Position: PRESIDENT
Credential:
Phone: 406-752-1724