Healthcare Provider Details

I. General information

NPI: 1477734416
Provider Name (Legal Business Name): POWELL COUNTY HEALTH DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2007
Last Update Date: 11/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 MILWAUKEE AVE STE 23
DEER LODGE MT
59722-1035
US

IV. Provider business mailing address

PO BOX 716
DEER LODGE MT
59722-0716
US

V. Phone/Fax

Practice location:
  • Phone: 406-846-2420
  • Fax: 406-846-3436
Mailing address:
  • Phone: 406-846-2420
  • Fax: 406-846-3436

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QF0050X
TaxonomyNon-Surgical Family Planning Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QP0905X
TaxonomyState or Local Public Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NANCY NELSON
Title or Position: PUBLIC HEALTH DIRECTOR
Credential: RN
Phone: 406-846-2420