Healthcare Provider Details

I. General information

NPI: 1821141342
Provider Name (Legal Business Name): HEMATOLOGY ONCOLOGY CENTERS OF THE NORTHERN ROCKIES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 10/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1025 9TH ST #B
CODY WY
82414-3440
US

IV. Provider business mailing address

PO BOX 30976
BILLINGS MT
59107-0976
US

V. Phone/Fax

Practice location:
  • Phone: 307-587-5622
  • Fax: 307-587-5657
Mailing address:
  • Phone: 406-238-6290
  • Fax: 406-238-6304

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number StateMT
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number StateMT

VIII. Authorized Official

Name: CATHY BEALER
Title or Position: CEO
Credential:
Phone: 406-238-6285