Provider Demographics
NPI:1720136195
Name:COUNTY OF TOOLE
Entity Type:Organization
Organization Name:COUNTY OF TOOLE
Other - Org Name:TOOLE COUNTY HEALTH DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COUNTY CLERK AND RECORDER
Authorized Official - Prefix:
Authorized Official - First Name:MARY ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:HARWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-424-8300
Mailing Address - Street 1:402 1ST ST S
Mailing Address - Street 2:
Mailing Address - City:SHELBY
Mailing Address - State:MT
Mailing Address - Zip Code:59474-1923
Mailing Address - Country:US
Mailing Address - Phone:406-424-5169
Mailing Address - Fax:406-424-2425
Practice Address - Street 1:402 1ST ST S
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:MT
Practice Address - Zip Code:59474-1923
Practice Address - Country:US
Practice Address - Phone:406-424-5169
Practice Address - Fax:406-424-2425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2011-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT3505814Medicaid
MTM011000119Medicare PIN
MT3505814Medicaid