1689722928 NPI number — MRS. RUBY K OSTERLOH M.A., CCC-A

Table of content: MRS. RUBY K OSTERLOH M.A., CCC-A (NPI 1689722928)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689722928 NPI number — MRS. RUBY K OSTERLOH M.A., CCC-A

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
OSTERLOH
Provider First Name:
RUBY
Provider Middle Name:
K
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
M.A., CCC-A
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MIERA
Provider Other First Name:
RUBY
Provider Other Middle Name:
K
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.A.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1689722928
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/19/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2900 4TH AVE N
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:
59101-1266
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
406-247-7112
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2900 4TH AVE N
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BILLINGS
Provider Business Practice Location Address State Name:
MT
Provider Business Practice Location Address Postal Code:
59101-1266
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
406-247-7112
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/05/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X , with the licence number:  187 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 3583732 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9583724 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1583724 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6583724 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4583724 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 5583724 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1689722928 . This is a "INDIAN HEALTH SERVICE, CONTRACT AUDIOLOGIST" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".
  • Identifier: 2583724 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2583732 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 36832 . This is a "BCBS ENT" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: 36835 . This is a "BCBS BT" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: 8583724 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0583724 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3583724 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0583732 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7583724 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1583732 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".




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