Organization
BOZEMAN DIALYSIS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH S LEWIS (SECRETARY)
(406) 585-1077
Entity
Organization
Contact information
Practice address
931 HIGHLAND BLVD, SUITE 3105, BOZEMAN, MT 59715-6911
(406) 585-5090
(406) 585-1070
Mailing address
931 HIGHLAND BLVD, SUITE 3105, BOZEMAN, MT 59715-6911
(406) 585-5090
(406) 585-1070
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0730218
MDCD PIN
MT
Enumeration date
12/28/2006
Last updated
03/14/2012
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