Provider Demographics
NPI:1790736429
Name:HEMATOLOGY ONCOLOGY CENTERS OF THE NORTHERN ROCKIES PC
Entity Type:Organization
Organization Name:HEMATOLOGY ONCOLOGY CENTERS OF THE NORTHERN ROCKIES PC
Other - Org Name:FRONTIER CANCER CENTER AND BLOOD INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:BEALER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-238-6285
Mailing Address - Street 1:PO BOX 30976
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59107-0976
Mailing Address - Country:US
Mailing Address - Phone:406-238-6290
Mailing Address - Fax:406-238-6961
Practice Address - Street 1:1315 GOLDEN VALLEY CIR
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-6746
Practice Address - Country:US
Practice Address - Phone:406-238-6290
Practice Address - Fax:406-238-6961
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-15
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
No2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT000080231Medicare ID - Type UnspecifiedMONTANA MEDICARE GROUP ID
MTCG0759Medicare ID - Type UnspecifiedRR MEDICARE MT GROUP ID
MT000080231Medicare PIN