Provider Demographics
NPI:1114013448
Name:BOTTOM LINE INCONTINENCE SUPPLY INC
Entity type:Organization
Organization Name:BOTTOM LINE INCONTINENCE SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:ROWAN
Authorized Official - Last Name:CAPPIS
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:406-799-7286
Mailing Address - Street 1:117 7TH STREET SOUTH
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59401
Mailing Address - Country:US
Mailing Address - Phone:406-452-2986
Mailing Address - Fax:406-452-2272
Practice Address - Street 1:117 7TH STREET SOUTH
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59401
Practice Address - Country:US
Practice Address - Phone:406-452-2986
Practice Address - Fax:406-452-2272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0562394Medicaid