Provider Demographics
NPI:1437342235
Name:DOCHARDY.COM LLC
Entity Type:Organization
Organization Name:DOCHARDY.COM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:S
Authorized Official - Last Name:HARDY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:406-442-2020
Mailing Address - Street 1:12 OLD MONTANA STATE HWY
Mailing Address - Street 2:
Mailing Address - City:MONTANA CITY
Mailing Address - State:MT
Mailing Address - Zip Code:59634-9687
Mailing Address - Country:US
Mailing Address - Phone:406-442-2020
Mailing Address - Fax:406-442-0101
Practice Address - Street 1:12 OLD MONTANA STATE HWY
Practice Address - Street 2:
Practice Address - City:MONTANA CITY
Practice Address - State:MT
Practice Address - Zip Code:59634-9687
Practice Address - Country:US
Practice Address - Phone:406-442-2020
Practice Address - Fax:406-442-0101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-24
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTMT624152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT1305750001Medicare NSC
MT000082584Medicare PIN