COPPER CITY RADIOLOGY PC NPI 1780112862

NPI Information

NPI: 1780112862
Provider Name: COPPER CITY RADIOLOGY PC
Classification: Radiology - 2085R0202X
Entity Type: Organization

Specialization: Diagnostic Radiology

CLIA Number: 27D2225290

Address:
400 S CLARK ST
BUTTE, MT
ZIP 59701
Phone: (406) 723-2658
Get Directions

COPPER CITY RADIOLOGY PC is a diagnostic radiology radiology in Butte, MT. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. COPPER CITY RADIOLOGY PC NPI is 1780112862. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

400 S CLARK ST
BUTTE, MT
ZIP 59701-328
Phone: (406) 723-2658
Fax: (406) 723-2624

The provider's authorized official is Hassan Massouh .
The authorized official title is Owner and has the following contact phone number (406) 461-2953.

The CLIA number assigned to this NPI record is 27D2225290 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/1/2017 and was last updated on 7/21/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085R0204X	Radiology	Vascular & Interventional Radiology			No
2	2085R0202X	Radiology	Diagnostic Radiology	10582	MONTANA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	98815	OTHER	MONTANA	BLUE CROSS/BLUE SHIELD
2	0085442	MEDICAID	MONTANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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