Healthcare Provider Details

I. General information

NPI: 1972197499
Provider Name (Legal Business Name): KALISPELL REGIONAL MEDICAL CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2021
Last Update Date: 03/02/2021
Certification Date: 03/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 WINDWARD WAY STE 101
KALISPELL MT
59901-3385
US

IV. Provider business mailing address

245 WINDWARD WAY STE 101
KALISPELL MT
59901-3385
US

V. Phone/Fax

Practice location:
  • Phone: 406-756-8488
  • Fax: 406-758-3234
Mailing address:
  • Phone: 406-756-8488
  • Fax: 406-758-3234

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM GIBSON
Title or Position: GENERAL COUNSEL
Credential:
Phone: 406-752-1724