MEDICARE: ROCKY MOUNTAIN SLEEP DISORDERS 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	261QS1200X	Sleep Disorder Diagnostic Clinic/Center

General Provider Information

NPI Number	:	1902120918
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROCKY MOUNTAIN SLEEP DISORDERS CENTER INC

Provider Business Mailing Address
First Line	:	1917 4TH ST S
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59405-4149
Country	:	US
Telephone Number	:	406-453-7570
Fax Number	:	406-452-2566

Provider Business Practice Location Address
First Line	:	1917 4TH ST S
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59405-4149
Country	:	US
Telephone Number	:	406-453-7570
Fax Number	:	406-452-2566

Authorized Official
Title or Position	:	CEO
Name	:	PAUL F SCHMOOK
Credential	:	RPSGT
Telephone Number	:	406-453-7570

Provider Enumeration Date	:	03/19/2010
Last Update Date	:	03/19/2010

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