Healthcare Provider Details

I. General information

NPI: 1134297179
Provider Name (Legal Business Name): INTERMOUNTAIN PLANNED PARENTHOOD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1844 BROADWATER AVE SUITE 4 (PPMT BILLINGS WEST)
BILLINGS MT
59102
US

IV. Provider business mailing address

1643 LEWIS AVE STE 211
BILLINGS MT
59102-4151
US

V. Phone/Fax

Practice location:
  • Phone: 406-656-9980
  • Fax: 406-656-9928
Mailing address:
  • Phone: 406-248-3637
  • Fax: 406-254-9330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QA0005X
TaxonomyAmbulatory Family Planning Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code261QF0050X
TaxonomyNon-Surgical Family Planning Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER PREMO
Title or Position: CLINICAL OPERATIONS COORDINATOR
Credential:
Phone: 406-830-3482