1841275211 NPI number — HELENA SURGICENTER, LLC

Table of content: (NPI 1841275211)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841275211 NPI number — HELENA SURGICENTER, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HELENA SURGICENTER, LLC
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:
1841275211
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2440 WINNE AVE
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
HELENA
Provider Business Mailing Address State Name:
MT
Provider Business Mailing Address Postal Code:
59601-4905
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
406-457-4200
Provider Business Mailing Address Fax Number:
406-457-4220

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2440 WINNE AVE
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
HELENA
Provider Business Practice Location Address State Name:
MT
Provider Business Practice Location Address Postal Code:
59601-4905
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
406-457-4200
Provider Business Practice Location Address Fax Number:
406-457-4220
Provider Enumeration Date:
12/08/2005

Additional Information

Authorized Official

Authorized Official Last Name:
HUBLEY
Authorized Official First Name:
KATHY
Authorized Official Middle Name:
L
Authorized Official Title or Position:
FINANCE DIRECTOR
Authorized Official Telephone Number:
406-457-4203

Provider Taxonomy Codes

  • Taxonomy code: 261QA1903X , with the licence number:  10469 , 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: 60402 . This is a "BLUE CROSS AND BLUE SHIEL" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".
  • Identifier: 96271003 . This is a "MT. BREAST & CERV. HLTH P" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".
  • Identifier: 0126583 . This is a "WASHINGTON WC" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 7122104 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0000350353 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".
  • Identifier: MSF0522205 . This is a "MONTANA STATE FUND" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".




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