Provider Demographics
NPI:1689124257
Name:ROCKY MOUNTAIN SLEEP DISORDERS CENTER, INC.
Entity Type:Organization
Organization Name:ROCKY MOUNTAIN SLEEP DISORDERS CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:FREDERICK
Authorized Official - Last Name:SCHMOOK
Authorized Official - Suffix:
Authorized Official - Credentials:RPSGT
Authorized Official - Phone:406-453-7570
Mailing Address - Street 1:1917 4TH ST S
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405-4149
Mailing Address - Country:US
Mailing Address - Phone:406-453-7570
Mailing Address - Fax:406-452-2566
Practice Address - Street 1:1917 4TH ST S
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-4149
Practice Address - Country:US
Practice Address - Phone:406-453-7570
Practice Address - Fax:406-452-2566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-07
Last Update Date:2016-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies