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PROVIDENCE SURGERY CENTER NPI 1407860745


NPI Information

NPI: 1407860745
Provider Name: PROVIDENCE SURGERY CENTER
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 27D0934160

Address:
902 N ORANGE ST
MISSOULA, MT
ZIP 59802
Phone: (406) 327-3300
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PROVIDENCE SURGERY CENTER is an ambulatory surgical clinic center in Missoula, MT. PROVIDENCE SURGERY CENTER NPI is 1407860745. The provider is registered as an organization entity type.

The provider's business location address is:

902 N ORANGE ST
MISSOULA, MT
ZIP 59802-916
Phone: (406) 327-3300
Fax: (406) 327-3302

The provider's authorized official is Nancy Howery Shooshtari .
The authorized official title is Ceo and has the following contact phone number (406) 327-3301.

The CLIA number assigned to this NPI record is 27D0934160 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/29/2006 and was last updated on 6/26/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QA1903XClinic/CenterAmbulatory Surgical10708MONTANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10350098MEDICAIDMONTANA
2000005699MEDICARE PINMONTANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.