Healthcare Provider Details

I. General information

NPI: 1912945544
Provider Name (Legal Business Name): KALISPELL REGIONAL MEDICAL CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 04/15/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 SUNNYVIEW LN
KALISPELL MT
59901-3164
US

IV. Provider business mailing address

111 SUNNYVIEW LN
KALISPELL MT
59901-3164
US

V. Phone/Fax

Practice location:
  • Phone: 406-257-6700
  • Fax: 406-257-3612
Mailing address:
  • Phone: 406-257-6700
  • Fax: 406-257-3612

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number10908
License Number StateMT

VIII. Authorized Official

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