Provider Demographics
NPI:1033718184
Name:HEALTH SERVICES MONTANA LLC
Entity Type:Organization
Organization Name:HEALTH SERVICES MONTANA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLSOPP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-310-7127
Mailing Address - Street 1:1059 E IRON EAGLE DR STE 175
Mailing Address - Street 2:
Mailing Address - City:EAGLE
Mailing Address - State:ID
Mailing Address - Zip Code:83616-7498
Mailing Address - Country:US
Mailing Address - Phone:208-310-7127
Mailing Address - Fax:208-912-0448
Practice Address - Street 1:HOLIDAY VILLAGE MALL 1753 HWY 2 NW
Practice Address - Street 2:STE 45
Practice Address - City:HAVRE
Practice Address - State:MT
Practice Address - Zip Code:59501
Practice Address - Country:US
Practice Address - Phone:208-310-7127
Practice Address - Fax:208-912-0448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-20
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0000OtherINSURANCE