Basic Information
Provider Information
NPI: 1841219698
EntityType: 2
ReplacementNPI:  
OrganizationName: YELLOWSTONE CITY-COUNTY HEALTH DEPARTMENT
LastName:  
FirstName:  
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Credential:  
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Mailing Information
Address1: 123 S 27TH ST
Address2:  
City: BILLINGS
State: MT
PostalCode: 591014200
CountryCode: US
TelephoneNumber: 4062473350
FaxNumber:  
Practice Location
Address1: 123 S 27TH ST
Address2:  
City: BILLINGS
State: MT
PostalCode: 591014200
CountryCode: US
TelephoneNumber: 4062473350
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/19/2006
LastUpdateDate: 01/27/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: RITZ
AuthorizedOfficialFirstName: SHELLI
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: CHIEF FINANCIAL OFFICER
AuthorizedOfficialTelephone: 4062473200
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MS.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/27/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QF0400X  Y Ambulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)

No ID Information.


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