Provider Demographics
NPI:1689241648
Name:INTERMOUNTAIN PLANNED PARENTHOOD
Entity Type:Organization
Organization Name:INTERMOUNTAIN PLANNED PARENTHOOD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:406-540-5130
Mailing Address - Street 1:1116 GRAND AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-4282
Mailing Address - Country:US
Mailing Address - Phone:406-540-5130
Mailing Address - Fax:
Practice Address - Street 1:1844 BROADWATER AVE STE 4
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-4875
Practice Address - Country:US
Practice Address - Phone:406-656-9980
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INTERMOUNTAIN PLANNED PARENTHOOD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-06-08
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site