Healthcare Provider Details

I. General information

NPI: 1497064364
Provider Name (Legal Business Name): INTERMOUNTAIN PLANNED PARENTHOOD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2010
Last Update Date: 09/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 4TH AVE N STE 201
BILLINGS MT
59101-1312
US

IV. Provider business mailing address

2525 4TH AVE N STE 201
BILLINGS MT
59101-1312
US

V. Phone/Fax

Practice location:
  • Phone: 406-869-5000
  • Fax: 406-254-9330
Mailing address:
  • Phone: 406-869-5000
  • Fax: 406-254-9330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0005X
TaxonomyAmbulatory Family Planning Facility
License Number34812
License Number StateMT

VIII. Authorized Official

Name: DR. JULIE DANAHER
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 406-860-6564