1568430791 NPI number — LIVINGSTON HEALTHCARE

Table of content: (NPI 1568430791)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568430791 NPI number — LIVINGSTON HEALTHCARE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LIVINGSTON HEALTHCARE
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
LIVINGSTON HEALTHCARE HOSPICE
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1568430791
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
320 ALPENGLOW LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LIVINGSTON
Provider Business Mailing Address State Name:
MT
Provider Business Mailing Address Postal Code:
59047-8506
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
406-222-5030
Provider Business Mailing Address Fax Number:
406-222-5040

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
320 ALPENGLOW LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LIVINGSTON
Provider Business Practice Location Address State Name:
MT
Provider Business Practice Location Address Postal Code:
59047-8506
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
406-222-5030
Provider Business Practice Location Address Fax Number:
406-222-5040
Provider Enumeration Date:
03/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ANCZAK
Authorized Official First Name:
DEBRA
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
406-823-6411

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X , with the licence number:  10612 , registered in the state of MT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 750061 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 30300 . This is a "BCBS" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com