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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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