Provider Demographics
NPI:1184643041
Name:PRAIRIE WINDS DME
Entity Type:Organization
Organization Name:PRAIRIE WINDS DME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:TOPE
Authorized Official - Suffix:
Authorized Official - Credentials:RCP
Authorized Official - Phone:406-889-3371
Mailing Address - Street 1:706 2ND ST SE
Mailing Address - Street 2:
Mailing Address - City:CUT BANK
Mailing Address - State:MT
Mailing Address - Zip Code:59427-3341
Mailing Address - Country:US
Mailing Address - Phone:406-873-5707
Mailing Address - Fax:406-873-3118
Practice Address - Street 1:706 2ND ST SE
Practice Address - Street 2:
Practice Address - City:CUT BANK
Practice Address - State:MT
Practice Address - Zip Code:59427-3341
Practice Address - Country:US
Practice Address - Phone:406-873-5707
Practice Address - Fax:406-873-3118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT5606874Medicaid
MT5031610001Medicare ID - Type Unspecified