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NPI Code Detail

MEDICARE: NEW WESTERN MANOR COMPANY LIMITED PARTNERSHIP

MEDICARE: NEW WESTERN MANOR COMPANY LIMITED PARTNERSHIP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13336L0003XLong Term Care Pharmacy210MT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12049830OTHERPK
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1023175452
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEW WESTERN MANOR COMPANY LIMITED PARTNERSHIP
Provider Business Mailing Address
First Line : 2115 CENTRAL AVE
Second Line :
City : BILLINGS
State : MT
Zip : 59102-4741
Country : US
Telephone Number : 406-656-2992
Fax Number : 406-651-5925
Provider Business Practice Location Address
First Line : 2115 CENTRAL AVE
Second Line :
City : BILLINGS
State : MT
Zip : 59102-4741
Country : US
Telephone Number : 406-656-2992
Fax Number : 406-651-5925
Authorized Official
Title or Position : AUTHORIZED OFFICIAL
Name : JAMES A WEICHERT
Credential :
Telephone Number : 952-361-8000
Provider Enumeration Date : 01/03/2007
Last Update Date : 11/02/2017

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