Healthcare Provider Details

I. General information

NPI: 1750459715
Provider Name (Legal Business Name): CENTRAL MONTANA MEDICAL FACILITIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 07/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

408 WENDELL AVE
LEWISTOWN MT
59457-2261
US

IV. Provider business mailing address

408 WENDELL AVE
LEWISTOWN MT
59457-2261
US

V. Phone/Fax

Practice location:
  • Phone: 406-535-7711
  • Fax: 406-535-6392
Mailing address:
  • Phone: 406-535-7711
  • Fax: 406-535-6392

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number StateMT

VIII. Authorized Official

Name: ALAN R ALDRICH
Title or Position: CFO
Credential:
Phone: 406-535-7711