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Contact Information

HOSPICE OF MISSOULA LLC
800 KENSINGTON AVE
SUITE 209
MISSOULA, MT59801-5674
 Phone: 406-543-4408
 Fax: 406-543-4418
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Hospice Care, Community Based

251G00000X B4[14] Hospice
Indicates primary specialty

NPI Profile & details for HOSPICE OF MISSOULA LLC

NPI # 1437143484
LBN Legal business name HOSPICE OF MISSOULA LLC
Authorized official GREGORY JACKSON - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 09/06/2005
Last updated 08/22/2020 - About 6 years ago
Identifiers
MT License # 9596
MT Medicaid 0750210
MT Other 350190 BLUE CROSS BLUE SHIELD
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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