1174515878 NPI number — ORTHO MONTANA, PSC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174515878 NPI number — ORTHO MONTANA, PSC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ORTHO MONTANA, PSC
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:
1174515878
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/05/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2900 12TH AVE N STE 140W
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:
59101-7507
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
406-237-5050
Provider Business Mailing Address Fax Number:
406-238-6599

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2900 12TH AVE N
Provider Second Line Business Practice Location Address:
SUITE 140W
Provider Business Practice Location Address City Name:
BILLINGS
Provider Business Practice Location Address State Name:
MT
Provider Business Practice Location Address Postal Code:
59101
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
406-237-5050
Provider Business Practice Location Address Fax Number:
406-238-6599
Provider Enumeration Date:
08/18/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
STRONG
Authorized Official First Name:
ROY
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
406-238-6587

Provider Taxonomy Codes

  • Taxonomy code: 207X00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: CT1848 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".