Provider Demographics
NPI:1700056132
Name:OCF WEST GROUP INC
Entity Type:Organization
Organization Name:OCF WEST GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INS BILLER
Authorized Official - Prefix:
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:R
Authorized Official - Last Name:CORTRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-563-3486
Mailing Address - Street 1:307 E PARK AVE
Mailing Address - Street 2:
Mailing Address - City:ANACONDA
Mailing Address - State:MT
Mailing Address - Zip Code:59711-2342
Mailing Address - Country:US
Mailing Address - Phone:406-563-4386
Mailing Address - Fax:
Practice Address - Street 1:307 E PARK AVE
Practice Address - Street 2:
Practice Address - City:ANACONDA
Practice Address - State:MT
Practice Address - Zip Code:59711-2342
Practice Address - Country:US
Practice Address - Phone:406-563-4386
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-29
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT7622208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0013889Medicaid
MTF63501Medicare UPIN