1437335544 NPI number — PUREVIEW HEALTH CENTER

Table of content: MARJORIE ANN CARON RN, CDE (NPI 1124221072)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437335544 NPI number — PUREVIEW HEALTH CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PUREVIEW HEALTH CENTER
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:
1437335544
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/18/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1930 9TH AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HELENA
Provider Business Mailing Address State Name:
MT
Provider Business Mailing Address Postal Code:
59601-4759
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
406-457-8905
Provider Business Mailing Address Fax Number:
406-457-8992

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
533 N LAST CHANCE GULCH
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HELENA
Provider Business Practice Location Address State Name:
MT
Provider Business Practice Location Address Postal Code:
59601-3346
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
406-500-2070
Provider Business Practice Location Address Fax Number:
406-500-2128
Provider Enumeration Date:
01/18/2008

Additional Information

Authorized Official

Authorized Official Last Name:
STEELEY
Authorized Official First Name:
JILL-MARIE
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
406-500-5020

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QF0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0730106 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".




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