Provider Demographics
NPI:1841719598
Name:CENTRAL MONTANA HEART & VASCULAR INSTITUTE LLC
Entity type:Organization
Organization Name:CENTRAL MONTANA HEART & VASCULAR INSTITUTE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ALRICH
Authorized Official - Middle Name:LIVINGSTON
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:434-227-6959
Mailing Address - Street 1:1313 BEARGRASS DR
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59404-6496
Mailing Address - Country:US
Mailing Address - Phone:434-227-6959
Mailing Address - Fax:
Practice Address - Street 1:401 15TH AVE S STE 202
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-4334
Practice Address - Country:US
Practice Address - Phone:434-227-6959
Practice Address - Fax:434-227-6959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-13
Last Update Date:2017-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center