PREMISE HEALTH OF MONTANA MEDICAL P C NPI 1629669031

NPI Information

NPI: 1629669031
Provider Name: PREMISE HEALTH OF MONTANA MEDICAL P C

Doing Business As: MISSOULA MONTANA HEALTH CENTER

Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

CLIA Number: 27D2078179

Address:
1211 S RESERVE ST STE 202
MISSOULA, MT
ZIP 59801
Phone: (406) 926-6722
Get Directions

PREMISE HEALTH OF MONTANA MEDICAL P C is a multi-specialty clinic center in Missoula, MT. PREMISE HEALTH OF MONTANA MEDICAL P C NPI is 1629669031. The provider is registered as an organization entity type.
The provider Is Doing Business As Missoula Montana Health Center.

The provider's business location address is:

1211 S RESERVE ST STE 202
MISSOULA, MT
ZIP 59801-102
Phone: (406) 926-6722
Fax: (406) 926-6823

The provider's authorized official is Jonathan Leizman .
The authorized official title is President and has the following contact phone number (216) 479-9063.

The CLIA number assigned to this NPI record is 27D2078179 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/28/2021 and was last updated on 10/13/2022.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM1300X	Clinic/Center	Multi-Specialty			Yes

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: 4/28/2024

NPI Synchronization or Removal

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