Basic Information
| Provider Information | |||||||||
| NPI: | 1811153711 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ST. JAMES HEALTHCARE PRIMARY CARE BILLING, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 400 S CLARK ST | ||||||||
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| City: | BUTTE | ||||||||
| State: | MT | ||||||||
| PostalCode: | 597012328 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 435 S CRYSTAL ST | ||||||||
| Address2: | |||||||||
| City: | BUTTE | ||||||||
| State: | MT | ||||||||
| PostalCode: | 597011506 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4064963600 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/31/2008 | ||||||||
| LastUpdateDate: | 07/31/2008 | ||||||||
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| AuthorizedOfficialLastName: | FANTINI | ||||||||
| AuthorizedOfficialFirstName: | STEPHANIE | ||||||||
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| AuthorizedOfficialTitleorPosition: | PHYSICIAN CONTRACTING | ||||||||
| AuthorizedOfficialTelephone: | 4067232436 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.