Central Mt Laboratory, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

8293 Issued in MT

Legal business name

CENTRAL MT LABORATORY, LLC

Practice address

3511 1St Ave N
Great Falls, MT 59401-3527

Phone

(406) 454-1211

Fax

(406) 454-9916

NPI assigned

Nov 13, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Lila Goodau

Title

Office Manager

Phone

(406) 454-1211

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1258070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258070400000",
    "number": "1023345949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3511 1ST AVE N",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594013527",
            "telephone_number": "406-454-1211",
            "fax_number": "406-454-9916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3511 1ST AVE N",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594013527",
            "telephone_number": "406-454-1211",
            "fax_number": "406-454-9916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL MT LABORATORY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-13",
        "last_updated": "2009-11-13",
        "status": "A",
        "authorized_official_last_name": "GOODAU",
        "authorized_official_first_name": "LILA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "406-454-1211",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MT",
            "license": "8293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Central Montana Heart & Vascular Institute LLC
• Central Montana Imaging LLC
• Central Montana Laboratory, LLC
• Central Montana Orthopedic Specialists PLLC
• Central Montana Surgery Center, Inc.
• Timothy Roy Chaffin, P.O.
• Hannah C Cham-a-Koon, R.D.
• Mary Ann Chandler, LPC, LCPC
• Vicki L Chapman, DO
• Jamina Charles, M.D.

• Family Medicine Physician in Great Falls, MT
• Providers in Great Falls, MT by specialty
• Family Medicine Physician in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.