Provider Demographics
NPI:1518997279
Name:HELENA LABORATORY PHYSICIANS
Entity Type:Organization
Organization Name:HELENA LABORATORY PHYSICIANS
Other - Org Name:HELENA LAB PHYSICIANS
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DON
Authorized Official - Middle Name:ALVIN
Authorized Official - Last Name:SCHULTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:406-461-1965
Mailing Address - Street 1:PO BOX 912420
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80291-2420
Mailing Address - Country:US
Mailing Address - Phone:406-502-1541
Mailing Address - Fax:406-502-1542
Practice Address - Street 1:2475 E BROADWAY ST
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-4928
Practice Address - Country:US
Practice Address - Phone:406-447-2427
Practice Address - Fax:406-444-2126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTCD5970OtherRR MCR
MT000008488Medicare PIN