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General NPI Number Information
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NPI Number | 1942540356
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Entity Type | Organization
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Legal Business Name | MICARE, LLC
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Dates
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Enumeration Date | 02/21/2013
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Last Update Date | 02/21/2013
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Provider Practice Location Address
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Address Line | 2075 OVERLAND AVENUE
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City | BILLINGS
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State | MT
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Zip | 59102
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Country | US
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Telephone | 406-869-6548
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Fax | 406-652-5380
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Provider Business Mailing Address
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Address Line | 2075 OVERLAND AVENUE
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City | BILLINGS
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State | MT
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Zip | 59102
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Country | US
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Telephone | 406-869-6548
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Fax | 406-245-3575
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Authorized Official
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Title or Position | DIRECTOR OF MICARE
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Name | MR. JARROD JASON WEENUM
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Credential |
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Telephone | 406-869-6548
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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