Provider Demographics
NPI:1750324828
Name:BEAVERHEAD COUNTY PUBLIC HEALTH
Entity Type:Organization
Organization Name:BEAVERHEAD COUNTY PUBLIC HEALTH
Other - Org Name:BEAVERHEAD FAMILY PLANNING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:MISS
Authorized Official - First Name:SHERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:GIRARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-683-4771
Mailing Address - Street 1:90 HIGHWAY 91 SOUTH
Mailing Address - Street 2:
Mailing Address - City:DILLON
Mailing Address - State:MT
Mailing Address - Zip Code:59725-3557
Mailing Address - Country:US
Mailing Address - Phone:406-683-4771
Mailing Address - Fax:406-683-3188
Practice Address - Street 1:90 HIGHWAY 91 SOUTH
Practice Address - Street 2:
Practice Address - City:DILLON
Practice Address - State:MT
Practice Address - Zip Code:59725-3557
Practice Address - Country:US
Practice Address - Phone:406-683-4771
Practice Address - Fax:406-683-3188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-14
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT099523251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT370521OtherBLUE CROSS BLUE SHIELD
MT4308850Medicaid