Provider Demographics
NPI:1962469544
Name:NORTHERN ROCKIES SURGERY CENTER LP
Entity Type:Organization
Organization Name:NORTHERN ROCKIES SURGERY CENTER LP
Other - Org Name:HEALTHSOUTH SURGERY CENTER OF BILLINGS, L.P.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:M
Authorized Official - Last Name:FIELDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-545-2572
Mailing Address - Street 1:940 N 30TH ST
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-0742
Mailing Address - Country:US
Mailing Address - Phone:406-248-7186
Mailing Address - Fax:
Practice Address - Street 1:940 N 30TH ST
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-0742
Practice Address - Country:US
Practice Address - Phone:406-248-7186
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-27
Last Update Date:2015-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT10126261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0000351050Medicaid
MT000005705Medicare PIN
490004954Medicare PIN