Provider Demographics
NPI:1750410395
Name:U S HEALTH DEPT OF HEALTH & HUMAN SERVICES
Entity type:Organization
Organization Name:U S HEALTH DEPT OF HEALTH & HUMAN SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MYRNA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-638-3464
Mailing Address - Street 1:P.O. BOX 780
Mailing Address - Street 2:418 HARDING STREET
Mailing Address - City:LODGE GRASS
Mailing Address - State:MT
Mailing Address - Zip Code:59050-0780
Mailing Address - Country:US
Mailing Address - Phone:406-639-2317
Mailing Address - Fax:406-639-2976
Practice Address - Street 1:418 HARDING STREET
Practice Address - Street 2:
Practice Address - City:LODGE GRASS
Practice Address - State:MT
Practice Address - Zip Code:59050-0780
Practice Address - Country:US
Practice Address - Phone:406-639-2317
Practice Address - Fax:406-639-2976
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
282NC0060X, 344600000X
MT282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
No344600000XTransportation ServicesTaxi
Provider Identifiers
StateIdentifier IDID TypeIssuer
271339Medicare Oscar/Certification
MT271339Medicare Oscar/Certification
MTHSZ027Medicare PIN