1013958446 NPI number — BILLINGS CLINIC

Table of content: (NPI 1013958446)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013958446 NPI number — BILLINGS CLINIC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BILLINGS CLINIC
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:
BILLINGS CLINIC ATRIUM PHARMACY
Provider Other Organization Name Type Code:
3
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:
1013958446
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/26/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 30977
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BILLINGS
Provider Business Mailing Address State Name:
MT
Provider Business Mailing Address Postal Code:
59107
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
406-238-2084
Provider Business Mailing Address Fax Number:
406-657-3861

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2800 10TH AVE N
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BILLINGS
Provider Business Practice Location Address State Name:
MT
Provider Business Practice Location Address Postal Code:
59101-0703
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
406-238-2084
Provider Business Practice Location Address Fax Number:
406-657-3861
Provider Enumeration Date:
06/09/2006

Additional Information

Authorized Official

Authorized Official Last Name:
QUINONES
Authorized Official First Name:
KATHLEEN
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
406-238-2500

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 333600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0002X , with the licence number: PHA-PHI-LIC-543 , registered in the state of MT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3336I0012X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 2049827 . This is a "PK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0222027 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".




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