1902195027 NPI number — YELLOWSTONE CITY COUNTY HEALTH DEPARTMENT

Table of content: (NPI 1902195027)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902195027 NPI number — YELLOWSTONE CITY COUNTY HEALTH DEPARTMENT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
YELLOWSTONE CITY COUNTY HEALTH DEPARTMENT
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:
1902195027
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/27/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
123 S 27TH ST
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:
59101-4200
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
406-247-3200
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2469 MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WORDEN
Provider Business Practice Location Address State Name:
MT
Provider Business Practice Location Address Postal Code:
59088-2227
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
406-967-2255
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/29/2011

Additional Information

Authorized Official

Authorized Official Last Name:
RITZ
Authorized Official First Name:
SHELLI
Authorized Official Middle Name:
Authorized Official Title or Position:
EVP & CFO
Authorized Official Telephone Number:
406-247-3200

Provider Taxonomy Codes

  • Taxonomy code: 261QF0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 261QF0400X , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000080527 . This is a "MEDICARE PART B PROVIDER" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".




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