Healthcare Provider Details
I. General information
NPI: 1962705376
Provider Name (Legal Business Name): KALISPELL REGIONAL MEDICAL CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/08/2010
Last Update Date: 04/29/2024
Certification Date: 04/29/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
350 HERITAGE WAY SUITE 1100
KALISPELL MT
59901-3158
US
IV. Provider business mailing address
350 HERITAGE WAY SUITE 1100
KALISPELL MT
59901-3158
US
V. Phone/Fax
- Phone: 406-752-8900
- Fax: 406-752-8909
- Phone: 406-752-8900
- Fax: 406-752-8909
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KEVIN
ABEL
Title or Position: PRESIDENT
Credential:
Phone: 406-752-1724