PROVIDENCE HEALTH & SERVICES MT

MISSOULA, MT
NPI1427096585
Doing Business AsPMG MT IHI
Entity TypeOrganization
Authorized ContactDONALD WAYNE ANDERSON
Director Reimbursement Admin
425-525-5392
Organization Subpart ?Yes
Primary Taxonomy207RC0000X Internal Medicine, Cardiovascular Disease
(Licence:   n/a)
Additional Taxonomies207RC0001X Internal Medicine, Clinical Cardiac Electrophysiology
(Licence:   n/a)
207RI0011X Internal Medicine, Interventional Cardiology
207RP1001X Internal Medicine, Pulmonary Disease
208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery)
363AM0700X Physician Assistant, Medical
(Licence:   n/a)
Enumeration Date2006-06-02
Last Update Date2018-06-04
Business Address
PROVIDENCE HEALTH & SERVICES MT
500 W BROADWAY ST SUITE 320
MISSOULA, MT 59802
Phone number: 406-329-5615
Mailing Address
PROVIDENCE HEALTH & SERVICES MT
PO BOX 12
LIBERTY LAKE, WA 99019-0012
Phone number: 406-329-5615