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Organization
HILLSIDE HEALTH CARE CENTER, LLC
Active
Organization
HILLSIDE HEALTH CARE CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES A. WEICHERT (AUTHORIZED OFFICIAL)
(952) 361-8000
Entity
Organization
Contact information
Practice address
4720 23RD AVE, MISSOULA, MT 59803-1137
(406) 251-5100
(406) 251-4278
Mailing address
1107 HAZELTINE BLVD STE 200, CHASKA, MN 55318-1070
(952) 361-8000
(952) 361-8060
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
755
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
217598
—
MT
01
—
2703785
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
12/27/2006
Last updated
10/16/2017
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