Organization
RIVER GATES NEPHROLOGY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GWENDOLYN A PINCOMB MD (OWNER)
(406) 457-4280
Entity
Organization
Contact information
Practice address
2525 E BROADWAY ST STE 202A, HELENA, MT 59601-8049
(406) 457-4280
(406) 457-4278
Mailing address
2525 E BROADWAY ST STE 202A, HELENA, MT 59601-8049
(406) 457-4280
(406) 457-4278
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
10181
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000083896
MEDICARE INDIVIDUAL
MT
05
—
0073355
—
MT
Enumeration date
11/14/2007
Last updated
01/23/2013
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