Provider Demographics
NPI:1003332818
Name:GREAT FALLS HEALTH SUPPLIES
Entity Type:Organization
Organization Name:GREAT FALLS HEALTH SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAHID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:855-278-8072
Mailing Address - Street 1:1720 10TH AVE S STE 4-151
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405-2680
Mailing Address - Country:US
Mailing Address - Phone:855-278-8072
Mailing Address - Fax:
Practice Address - Street 1:1720 10TH AVE., SOUTH
Practice Address - Street 2:SUITE 4-151
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405
Practice Address - Country:US
Practice Address - Phone:855-278-8072
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies