Provider Demographics
NPI:1508656521
Name:COUNTY OF MISSOULA
Entity type:Organization
Organization Name:COUNTY OF MISSOULA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:BOMBARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-258-4987
Mailing Address - Street 1:301 W ALDER ST
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59802-4123
Mailing Address - Country:US
Mailing Address - Phone:406-258-3363
Mailing Address - Fax:406-258-4913
Practice Address - Street 1:301 W ALDER ST
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-4123
Practice Address - Country:US
Practice Address - Phone:406-258-3363
Practice Address - Fax:406-258-4913
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF MISSOULA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Single Specialty