1467505941 NPI number — TOWN OF WHITEHALL

Table of content: (NPI 1467505941)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467505941 NPI number — TOWN OF WHITEHALL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TOWN OF WHITEHALL
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:
1467505941
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/19/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 529
Provider Second Line Business Mailing Address:
2 NORTH WHITEHALL STREET
Provider Business Mailing Address City Name:
WHITEHALL
Provider Business Mailing Address State Name:
MT
Provider Business Mailing Address Postal Code:
59759-0529
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
406-287-3972
Provider Business Mailing Address Fax Number:
406-287-5088

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2 NORTH WHITEHALL STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WHITEHALL
Provider Business Practice Location Address State Name:
MT
Provider Business Practice Location Address Postal Code:
59759-0529
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
406-287-3972
Provider Business Practice Location Address Fax Number:
406-287-5088
Provider Enumeration Date:
01/19/2007

Additional Information

Authorized Official

Authorized Official Last Name:
JANIK
Authorized Official First Name:
FRANCINE
Authorized Official Middle Name:
GIONO
Authorized Official Title or Position:
SERVICE DIRECTOR
Authorized Official Telephone Number:
406-287-3972

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  35 , registered in the state of MT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 448422 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".




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