Healthcare Provider Details

I. General information

NPI: 1427798024
Provider Name (Legal Business Name): BILLINGS CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2022
Last Update Date: 01/31/2023
Certification Date: 01/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3905 WELLNESS WAY
BOZEMAN MT
59718-2402
US

IV. Provider business mailing address

3905 WELLNESS WAY
BOZEMAN MT
59718-2402
US

V. Phone/Fax

Practice location:
  • Phone: 406-898-1250
  • Fax: 406-898-1259
Mailing address:
  • Phone: 406-898-1200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: KATHLEEN ROSSIE QUINONES
Title or Position: CFO
Credential:
Phone: 406-435-6445