=====================================================
General NPI Number Information
=====================================================
NPI Number | 1902120918
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ROCKY MOUNTAIN SLEEP DISORDERS CENTER INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/19/2010
-----------------------------------------------------
Last Update Date | 03/19/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1917 4TH ST S
-----------------------------------------------------
City | GREAT FALLS
-----------------------------------------------------
State | MT
-----------------------------------------------------
Zip | 59405-4149
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 406-453-7570
-----------------------------------------------------
Fax | 406-452-2566
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1917 4TH ST S
-----------------------------------------------------
City | GREAT FALLS
-----------------------------------------------------
State | MT
-----------------------------------------------------
Zip | 59405-4149
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 406-453-7570
-----------------------------------------------------
Fax | 406-452-2566
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | PAUL F SCHMOOK
-----------------------------------------------------
Credential | RPSGT
-----------------------------------------------------
Telephone | 406-453-7570
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QS1200X
-----------------------------------------------------
Taxonomy Name | Sleep Disorder Diagnostic Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------