Provider Demographics
NPI:1144385188
Name:WEST PARK PARTNERSHIP
Entity Type:Organization
Organization Name:WEST PARK PARTNERSHIP
Other - Org Name:WESTPARK VILLAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT OF MANAGING GENERAL PATNE
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:B
Authorized Official - Last Name:GOODMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-361-8000
Mailing Address - Street 1:2351 SOLOMON AVE
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-2879
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2351 SOLOMON AVE
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-2879
Practice Address - Country:US
Practice Address - Phone:406-652-1508
Practice Address - Fax:406-655-9442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT8113336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2705599OtherOTHER ID NUMBER-COMMERCIAL NUMBER