Provider Demographics
NPI:1972671931
Name:MOUNTAIN VIEW EYECARE PC
Entity Type:Organization
Organization Name:MOUNTAIN VIEW EYECARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:G
Authorized Official - Last Name:BERBOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:406-442-3937
Mailing Address - Street 1:301 SADDLE DRIVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601
Mailing Address - Country:US
Mailing Address - Phone:406-442-3938
Mailing Address - Fax:406-442-3366
Practice Address - Street 1:301 SADDLE DRIVE
Practice Address - Street 2:SUITE B
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601
Practice Address - Country:US
Practice Address - Phone:406-442-3938
Practice Address - Fax:406-442-3366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT5741980001Medicare NSC