Provider Demographics
NPI:1114089166
Name:MONTANA HEALTH RESEARCH INSTITUTE INC
Entity Type:Organization
Organization Name:MONTANA HEALTH RESEARCH INSTITUTE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL RESEARCH ASSISTANT, CLAIMS
Authorized Official - Prefix:MS
Authorized Official - First Name:NICKIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:BURKE
Authorized Official - Suffix:
Authorized Official - Credentials:CRA
Authorized Official - Phone:406-652-6630
Mailing Address - Street 1:2101 BROADWATER AVE
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-4711
Mailing Address - Country:US
Mailing Address - Phone:406-652-6630
Mailing Address - Fax:406-652-6928
Practice Address - Street 1:2101 BROADWATER AVE
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-4711
Practice Address - Country:US
Practice Address - Phone:406-652-6630
Practice Address - Fax:406-652-6928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-15
Last Update Date:2009-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT0600017294MISCELLANE1744R1102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1744R1102XOther Service ProvidersSpecialistResearch StudyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT000091875OtherBCBS PROVIDER #
MT470001377OtherRR MEDICARE PROVIDER #
MT77039Medicaid
MT77039Medicaid