1053440925 NPI number — BOZEMAN SCHOOL DISTRICT #7

Table of content: (NPI 1053440925)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053440925 NPI number — BOZEMAN SCHOOL DISTRICT #7

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BOZEMAN SCHOOL DISTRICT #7
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:
6
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:
1053440925
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/26/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
404 W MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BOZEMAN
Provider Business Mailing Address State Name:
MT
Provider Business Mailing Address Postal Code:
59715-4579
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
406-522-6056
Provider Business Mailing Address Fax Number:
406-522-6090

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
404 W MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BOZEMAN
Provider Business Practice Location Address State Name:
MT
Provider Business Practice Location Address Postal Code:
59715-4579
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
406-522-6056
Provider Business Practice Location Address Fax Number:
406-522-6090
Provider Enumeration Date:
03/05/2007

Additional Information

Authorized Official

Authorized Official Last Name:
JOHNSON
Authorized Official First Name:
STEVEN
Authorized Official Middle Name:
DWAYNE
Authorized Official Title or Position:
ASSISTANT SUPERINTENDENT OF BUSINES
Authorized Official Telephone Number:
406-522-6042

Provider Taxonomy Codes

  • Taxonomy code: 251300000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0165217 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com