=====================================================
General NPI Number Information
=====================================================
NPI Number | 1235157280
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | METWEST INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/18/2006
-----------------------------------------------------
Last Update Date | 10/03/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2900 12TH AVE N
-----------------------------------------------------
City | BILLINGS
-----------------------------------------------------
State | MT
-----------------------------------------------------
Zip | 59101-7506
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 406-238-1800
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1001 ADAMS AVE 2ND FLOOR MRGOV
-----------------------------------------------------
City | NORRISTOWN
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19403-2401
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 484-676-7331
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | VP NATIONAL BILLING
-----------------------------------------------------
Name | GERALD SCOTT CARTIER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 484-676-7000
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 291U00000X
-----------------------------------------------------
Taxonomy Name | Clinical Medical Laboratory
-----------------------------------------------------
License Number | 27D0652468
-----------------------------------------------------
License Number State | MT
-----------------------------------------------------