Provider Demographics
NPI:1760837744
Name:ACTION OUTSIDE
Entity Type:Organization
Organization Name:ACTION OUTSIDE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANA
Authorized Official - Middle Name:
Authorized Official - Last Name:SWENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-465-9159
Mailing Address - Street 1:PO BOX 158
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:MT
Mailing Address - Zip Code:59638-0158
Mailing Address - Country:US
Mailing Address - Phone:406-465-9159
Mailing Address - Fax:
Practice Address - Street 1:1419 HELENA AVE
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-3024
Practice Address - Country:US
Practice Address - Phone:406-465-9159
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-27
Last Update Date:2016-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies