Provider Demographics
NPI:1457647877
Name:KALISPELL REGIONAL MEDICAL CENTER INC
Entity Type:Organization
Organization Name:KALISPELL REGIONAL MEDICAL CENTER INC
Other - Org Name:GLACIER NEUROSCIENCE AND SPINE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VELINDA
Authorized Official - Middle Name:J
Authorized Official - Last Name:STEVENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-752-1724
Mailing Address - Street 1:200 COMMONS WAY
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-1914
Mailing Address - Country:US
Mailing Address - Phone:406-752-5095
Mailing Address - Fax:406-752-5058
Practice Address - Street 1:200 COMMONS WAY
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-1914
Practice Address - Country:US
Practice Address - Phone:406-752-5095
Practice Address - Fax:406-752-5058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-23
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty