Healthcare Provider Details

I. General information

NPI: 1477676443
Provider Name (Legal Business Name): LIVINGSTON HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 09/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 ALPENGLOW LN
LIVINGSTON MT
59047-8506
US

IV. Provider business mailing address

320 ALPENGLOW LN
LIVINGSTON MT
59047-8506
US

V. Phone/Fax

Practice location:
  • Phone: 406-823-6414
  • Fax: 406-823-6287
Mailing address:
  • Phone: 406-823-6414
  • Fax: 406-823-6287

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BREN LOWE
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 406-823-6411