Provider Demographics
NPI:1952554982
Name:CASCADE CITY COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:CASCADE CITY COUNTY HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERM HEALTH OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICH
Authorized Official - Middle Name:
Authorized Official - Last Name:CORNWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-454-6950
Mailing Address - Street 1:115 4TH ST S
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59401-3618
Mailing Address - Country:US
Mailing Address - Phone:406-454-6950
Mailing Address - Fax:406-453-3357
Practice Address - Street 1:115 4TH ST S
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59401-3618
Practice Address - Country:US
Practice Address - Phone:406-454-6950
Practice Address - Fax:406-453-3357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-04
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT486251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare