1730283979 NPI number — ST. PETER'S HEALTH

Table of content: (NPI 1730283979)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730283979 NPI number — ST. PETER'S HEALTH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ST. PETER'S HEALTH
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:
1730283979
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/08/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2475 E BROADWAY ST
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:
59601-4928
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
406-444-2100
Provider Business Mailing Address Fax Number:
406-444-2389

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
201 S CALIFORNIA ST
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:
59601-4974
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
406-444-2244
Provider Business Practice Location Address Fax Number:
406-447-2540
Provider Enumeration Date:
09/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MURRAY
Authorized Official First Name:
DEVON
Authorized Official Middle Name:
Authorized Official Title or Position:
SR. DIRECTOR OF REVENUE CYCLE
Authorized Official Telephone Number:
406-447-2787

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  10740 , 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: 0000068773 . This is a "BCBSMT" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".
  • Identifier: 740883 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".




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