Healthcare Provider Details

I. General information

NPI: 1639328933
Provider Name (Legal Business Name): KALISPELL REGIONAL MEDICAL CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2008
Last Update Date: 09/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 HERITAGE WAY SUITE 2100
KALISPELL MT
59901-3158
US

IV. Provider business mailing address

350 HERITAGE WAY SUITE 2100
KALISPELL MT
59901-3158
US

V. Phone/Fax

Practice location:
  • Phone: 406-257-8992
  • Fax: 406-257-8996
Mailing address:
  • Phone: 406-257-8992
  • Fax: 406-257-8996

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: VELINDA J STEVENS
Title or Position: PRESIDENT
Credential:
Phone: 406-752-1724