Provider Demographics
NPI:1972596880
Name:MONTANA PEDIATRIC CRITICAL CARE, PC
Entity Type:Organization
Organization Name:MONTANA PEDIATRIC CRITICAL CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:D
Authorized Official - Last Name:SWIFT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-697-0082
Mailing Address - Street 1:3006 S MARYLAND PKWY
Mailing Address - Street 2:505
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89109-2218
Mailing Address - Country:US
Mailing Address - Phone:702-697-0082
Mailing Address - Fax:702-369-5827
Practice Address - Street 1:1233 N 30TH ST
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-0127
Practice Address - Country:US
Practice Address - Phone:888-350-2911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-25
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care MedicineGroup - Single Specialty