1922698737 NPI number — DOWNTOWN HEALTH CARE CLINIC, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922698737 NPI number — DOWNTOWN HEALTH CARE CLINIC, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DOWNTOWN HEALTH CARE CLINIC, 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:
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:
1922698737
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/22/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1437
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HAMILTON
Provider Business Mailing Address State Name:
MT
Provider Business Mailing Address Postal Code:
59840-1437
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
406-363-7003
Provider Business Mailing Address Fax Number:
406-363-7001

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
106 S 2ND ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAMILTON
Provider Business Practice Location Address State Name:
MT
Provider Business Practice Location Address Postal Code:
59840-2517
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
406-210-7284
Provider Business Practice Location Address Fax Number:
406-363-7001
Provider Enumeration Date:
01/25/2021

Additional Information

Authorized Official

Authorized Official Last Name:
REYNOLDS
Authorized Official First Name:
SUSAN
Authorized Official Middle Name:
MARIE
Authorized Official Title or Position:
ARNP, FNP-BC
Authorized Official Telephone Number:
406-363-7003

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com