Provider Demographics
NPI:1376694497
Name:SOUTHWEST MONTANA SLEEP DIAGNOSTICS INC.
Entity Type:Organization
Organization Name:SOUTHWEST MONTANA SLEEP DIAGNOSTICS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TOM
Authorized Official - Middle Name:P
Authorized Official - Last Name:SCHRAPPS
Authorized Official - Suffix:I
Authorized Official - Credentials:
Authorized Official - Phone:406-782-4595
Mailing Address - Street 1:PO BOX 621
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59703-0621
Mailing Address - Country:US
Mailing Address - Phone:406-782-4595
Mailing Address - Fax:406-782-4355
Practice Address - Street 1:400 W GRANITE ST
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-9145
Practice Address - Country:US
Practice Address - Phone:406-782-4595
Practice Address - Fax:406-782-4355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0760002Medicaid