Provider Demographics
NPI:1245105865
Name:BOZEMAN HEALTH DEACONESS HOSPITAL
Entity type:Organization
Organization Name:BOZEMAN HEALTH DEACONESS HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PAYER ENROLLMENT SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:ANGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LIBERTINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-980-0649
Mailing Address - Street 1:931 HIGHLAND BLVD STE 3105
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-6912
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:931 HIGHLAND BLVD STE 3105
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-6912
Practice Address - Country:US
Practice Address - Phone:406-414-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-06
Last Update Date:2025-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site