Provider Demographics
NPI: | 1972982981 |
---|---|
Name: | KALISPELL REGIONAL MEDICAL CENTER INC |
Entity type: | Organization |
Organization Name: | KALISPELL REGIONAL MEDICAL CENTER INC |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT/CHIEF EXECUTIVE OFFICER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | CRAIG |
Authorized Official - Middle Name: | J |
Authorized Official - Last Name: | LAMBRECHT |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 406-752-1724 |
Mailing Address - Street 1: | 210 SUNNYVIEW LN |
Mailing Address - Street 2: | SUITE 104 |
Mailing Address - City: | KALISPELL |
Mailing Address - State: | MT |
Mailing Address - Zip Code: | 59901-3135 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 406-755-6550 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 210 SUNNYVIEW LN |
Practice Address - Street 2: | SUITE 104 |
Practice Address - City: | KALISPELL |
Practice Address - State: | MT |
Practice Address - Zip Code: | 59901-3135 |
Practice Address - Country: | US |
Practice Address - Phone: | 406-755-6550 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2015-05-22 |
Last Update Date: | 2023-11-27 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Group - Multi-Specialty |