1811954662 NPI number — COMMUNITY NURSING INC.

Table of content: (NPI 1811954662)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811954662 NPI number — COMMUNITY NURSING INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COMMUNITY NURSING 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:
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:
1811954662
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/15/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1107 HAZELTINE BLVD STE 200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHASKA
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55318-1070
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
952-361-8000
Provider Business Mailing Address Fax Number:
952-361-8058

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2651 SOUTH AVE W
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MISSOULA
Provider Business Practice Location Address State Name:
MT
Provider Business Practice Location Address Postal Code:
59804-6405
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
406-728-9162
Provider Business Practice Location Address Fax Number:
406-543-8128
Provider Enumeration Date:
04/26/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WEICHERT
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
A.
Authorized Official Title or Position:
AUTHORIZED OFFICIAL
Authorized Official Telephone Number:
952-361-8000

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 314000000X , with the licence number: 10068 , 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: 0532519 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0344760 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0310180 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4073-2 . This is a "BCBS OF MONTANA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 611494 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0344773 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0217685 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".




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