Healthcare Provider Details

I. General information

NPI: 1366594152
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: 01/18/2007
Last Update Date: 09/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

532 VAL VISTA ST STE 103
SHERIDAN WY
82801-3655
US

IV. Provider business mailing address

PO BOX 30976
BILLINGS MT
59107-0976
US

V. Phone/Fax

Practice location:
  • Phone: 307-674-5400
  • Fax: 307-674-5405
Mailing address:
  • Phone: 406-238-6290
  • Fax: 406-238-6961

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number StateWY

VIII. Authorized Official

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