Provider Demographics
NPI:1437514619
Name:HIGHLANDS VETERINARY HOSPITAL
Entity Type:Organization
Organization Name:HIGHLANDS VETERINARY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CINDI
Authorized Official - Middle Name:
Authorized Official - Last Name:COSTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-299-3700
Mailing Address - Street 1:840 S MONTANA ST
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-2859
Mailing Address - Country:US
Mailing Address - Phone:406-299-3700
Mailing Address - Fax:406-299-3002
Practice Address - Street 1:840 S MONTANA ST
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-2859
Practice Address - Country:US
Practice Address - Phone:406-299-3700
Practice Address - Fax:406-299-3002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-15
Last Update Date:2015-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT51A6D6442DMedicaid