Provider Demographics
NPI:1487639233
Name:EAGLE CALF TECHNICAL CORPORATION
Entity Type:Organization
Organization Name:EAGLE CALF TECHNICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LELAND
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:GROUND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-338-5182
Mailing Address - Street 1:PO BOX 2989
Mailing Address - Street 2:
Mailing Address - City:BROWNING
Mailing Address - State:MT
Mailing Address - Zip Code:59417-2989
Mailing Address - Country:US
Mailing Address - Phone:406-338-5182
Mailing Address - Fax:406-338-5917
Practice Address - Street 1:324 POPIMI ST
Practice Address - Street 2:
Practice Address - City:BROWNING
Practice Address - State:MT
Practice Address - Zip Code:59417
Practice Address - Country:US
Practice Address - Phone:406-338-5182
Practice Address - Fax:406-338-5917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-14
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
MT1228410001Medicare NSC