MEDICARE: KALISPELL REGIONAL MEDICAL CENTER INC

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
1	261Q00000X	Clinic/Center
2	207Q00000X	Family Medicine Physician	6357	MT

General Provider Information

NPI Number	:	1356394944
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KALISPELL REGIONAL MEDICAL CENTER INC

Provider Business Mailing Address
First Line	:	202 CONWAY DRIVE
Second Line	:	SUITE 100
City	:	KALISPELL
State	:	MT
Zip	:	59901-3153
Country	:	US
Telephone Number	:	406-751-5666
Fax Number	:	406-755-0971

Provider Business Practice Location Address
First Line	:	202 CONWAY DRIVE
Second Line	:	SUITE 100
City	:	KALISPELL
State	:	MT
Zip	:	59901-3153
Country	:	US
Telephone Number	:	406-751-5666
Fax Number	:	406-755-0971

Authorized Official
Title or Position	:	PRESIDENT
Name	:	KEVIN ABEL
Credential	:
Telephone Number	:	406-752-1724

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	04/29/2024

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