Provider Demographics
NPI:1578747689
Name:GRANITE COUNTY
Entity Type:Organization
Organization Name:GRANITE COUNTY
Other - Org Name:GRANITE COUNTY PUBLIC HEALTH DEPARTMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LEIGH ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLMES
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:406-563-4244
Mailing Address - Street 1:PO BOX 312
Mailing Address - Street 2:212 E FRONT STREET
Mailing Address - City:DRUMMOND
Mailing Address - State:MT
Mailing Address - Zip Code:59832
Mailing Address - Country:US
Mailing Address - Phone:406-531-5442
Mailing Address - Fax:406-288-0330
Practice Address - Street 1:212 W. FRONT ST.
Practice Address - Street 2:
Practice Address - City:DRUMMOND
Practice Address - State:MT
Practice Address - Zip Code:59832
Practice Address - Country:US
Practice Address - Phone:406-531-5442
Practice Address - Fax:406-534-7624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-26
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT251K00000X
251K00000X, 261QP0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
No251K00000XAgenciesPublic Health or Welfare