| Heavens Peak Healthcare Llc | |
|
9540 9th St W Columbia Falls MT 59912 | |
| (406) 752-8120 | |
| Not Available |
| Full Name | Heavens Peak Healthcare Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 9540 9th St W, Columbia Falls, Montana |
| Authorized Official Name and Position | Laura Chrystine Hall (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 4062508717 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Heavens Peak Healthcare Llc 9540 9th St W Columbia Falls MT 59912 Ph: (406) 752-8120 | Heavens Peak Healthcare Llc 9540 9th St W Columbia Falls MT 59912 Ph: (406) 752-8120 |
| NPI Number | 1952881138 |
|---|---|
| Provider Enumeration Date | 08/17/2018 |
| Last Update Date | 08/17/2018 |
| Medicare PECOS PAC ID | 5890030209 |
|---|---|
| Medicare Enrollment ID | O20181212003132 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952881138 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Primary |
| Provider Name | Laura C Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164696506 PECOS PAC ID: 7113098542 Enrollment ID: I20080612000458 |
| Provider Name | John F Lewison |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497795678 PECOS PAC ID: 0446237556 Enrollment ID: I20081205000276 |
| Provider Name | David Allen Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508456567 PECOS PAC ID: 6709256829 Enrollment ID: I20230106001362 |
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