Provider Demographics
NPI:1598776643
Name:BENEFIS HEALTHCARE PRACTITIONERS, PC
Entity Type:Organization
Organization Name:BENEFIS HEALTHCARE PRACTITIONERS, PC
Other - Org Name:SUPPLEMENTAL CARDIOVASCULAR SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVEDIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GUY
Authorized Official - Middle Name:T
Authorized Official - Last Name:HAYTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-268-0082
Mailing Address - Street 1:2519 13TH AVE S
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405-5178
Mailing Address - Country:US
Mailing Address - Phone:406-268-0082
Mailing Address - Fax:406-268-0084
Practice Address - Street 1:1101 26TH ST S
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-5161
Practice Address - Country:US
Practice Address - Phone:406-455-5770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty