GLACIER ONCOLOGY, PLLC; NPI #1275789901

Contact Information

GLACIER ONCOLOGY, PLLC

75 CLAREMONT ST
SUITE E
KALISPELL, MT 59901-3585

Phone: 406-752-7600
Fax: 406-752-7614
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Oncology	261QX0200X

Indicates primary specialty

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NPI Profile & details for GLACIER ONCOLOGY, PLLC

NPI Number 1275789901

LBN Legal business name GLACIER ONCOLOGY, PLLC

Authorized official MICHAEL GOODMAN - (SOLE PROPRIETOR)

Entity Organization

Organization subpart ¹ No

Enumeration date 08/13/2008

Last updated 08/13/2008 - About 18 years ago

Identifiers

MT	License #	8025
MT	Medicaid	0105825
MT	Other	011071	BLUE CROSS BLUE SHIELD
MT	Other	830004450	RAILROAD MEDICARE

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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