1639921745 NPI number — ADVANCED ISOTOPES OF MONTANA

Table of content: ANA CAROLINA RODRIGUES BS (NPI 1780628347)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639921745 NPI number — ADVANCED ISOTOPES OF MONTANA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADVANCED ISOTOPES OF MONTANA
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:
Provider Other Organization Name Type Code:
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:
1639921745
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/02/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1261
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MANHATTAN
Provider Business Mailing Address State Name:
MT
Provider Business Mailing Address Postal Code:
59741-1261
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
406-284-2121
Provider Business Mailing Address Fax Number:
406-284-2345

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
225 WOODEN SHOE LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MANHATTAN
Provider Business Practice Location Address State Name:
MT
Provider Business Practice Location Address Postal Code:
59741-8172
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
406-284-2121
Provider Business Practice Location Address Fax Number:
406-284-2345
Provider Enumeration Date:
04/02/2024

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HART
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
RAY
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
208-339-5120

Provider Taxonomy Codes

  • Taxonomy code: 3336N0007X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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