STATE OF MONTANA; NPI #1639475411

Contact Information

STATE OF MONTANA

1400 BROADWAY RM A116
HELENA, MT 59620

Phone: 406-444-3529
Fax: 406-444-2750
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Oral and Maxillofacial Surgery	261QS0112X

Indicates primary specialty

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NPI Profile & details for STATE OF MONTANA

NPI # 1639475411

LBN Legal business name STATE OF MONTANA

Authorized official MICHELE O'DONNELL - (BILLING AGENT)

Entity Organization

Organization subpart ¹ Yes

Enumeration date 01/27/2011

Last updated 01/27/2011 - About 15 years ago

Identifiers

MT	Medicaid	0260000
MT	Other	92046	BLUE CROSS BLUE SHELD OF MONTANA
MT	Other	92056	BLUE CROSS BLUE SHELD OF MONTANA
MT	Other	99248	BLUE CROSS BLUE SHELD OF MONTANA

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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