Provider Demographics
NPI:1396766903
Name:NORTHEAST MONTANA HEALTH SERVICES, INC.
Entity type:Organization
Organization Name:NORTHEAST MONTANA HEALTH SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:BALAND
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:512-484-4850
Mailing Address - Street 1:211 H. ST. EAST
Mailing Address - Street 2:
Mailing Address - City:POPLAR
Mailing Address - State:MT
Mailing Address - Zip Code:59255-0038
Mailing Address - Country:US
Mailing Address - Phone:406-768-6100
Mailing Address - Fax:406-768-6160
Practice Address - Street 1:211 H. ST. EAST
Practice Address - Street 2:
Practice Address - City:POPLAR
Practice Address - State:MT
Practice Address - Zip Code:59255-0038
Practice Address - Country:US
Practice Address - Phone:406-768-6100
Practice Address - Fax:406-768-6160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2023-11-05
Deactivation Date:2018-05-16
Deactivation Code:
Reactivation Date:2018-06-11
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT3100188Medicaid
MT0442364Medicaid
MT4100485Medicaid
MT0220235Medicaid
MT4100485Medicaid
MT0220235Medicaid