1609120799 NPI number — MONTANA HEALTH NETWORK, INC

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 1609120799 NPI number — MONTANA HEALTH NETWORK, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MONTANA HEALTH NETWORK, INC
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:
1609120799
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/29/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11 S 7TH ST
Provider Second Line Business Mailing Address:
SUITE 241
Provider Business Mailing Address City Name:
MILES CITY
Provider Business Mailing Address State Name:
MT
Provider Business Mailing Address Postal Code:
59301-3216
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
406-234-1420
Provider Business Mailing Address Fax Number:
406-234-1423

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1925 GRAND AVE
Provider Second Line Business Practice Location Address:
SUITE 134
Provider Business Practice Location Address City Name:
BILLINGS
Provider Business Practice Location Address State Name:
MT
Provider Business Practice Location Address Postal Code:
59102-2764
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
406-256-1084
Provider Business Practice Location Address Fax Number:
406-256-1426
Provider Enumeration Date:
10/29/2012

Additional Information

Authorized Official

Authorized Official Last Name:
BASTIAN
Authorized Official First Name:
JANET
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
406-234-1420

Provider Taxonomy Codes

  • Taxonomy code: 251B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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