Provider Demographics
NPI:1902967839
Name:COUNTY OF MINERAL
Entity Type:Organization
Organization Name:COUNTY OF MINERAL
Other - Org Name:MINERAL COUNTY HEALTH DEPT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:STEVENS
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:406-822-3564
Mailing Address - Street 1:1203 5TH AVE EAST
Mailing Address - Street 2:
Mailing Address - City:SUPERIOR
Mailing Address - State:MT
Mailing Address - Zip Code:59872-9618
Mailing Address - Country:US
Mailing Address - Phone:406-822-3564
Mailing Address - Fax:406-822-3745
Practice Address - Street 1:1203 5TH AVE EAST
Practice Address - Street 2:
Practice Address - City:SUPERIOR
Practice Address - State:MT
Practice Address - Zip Code:59872-9618
Practice Address - Country:US
Practice Address - Phone:406-822-3564
Practice Address - Fax:406-822-3745
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MINERAL COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-13
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0003500991Medicaid
MT031418OtherBLUE CROSS BLUE SHIELD
MT0003500991Medicaid