Organization
RAVALLI COUNTY
Active
Parent organization
RAVALLI COUNTY
Other names
Ravalli County Public Health
Organization subpart
Yes
Provider details
NPI number
Legal business name
RAVALLI COUNTY
Authorized official
MS. KIM A SQUIRES FNP/C (FAMILY NURSE PRACTITIONER)
(406) 375-6670
Entity
Organization
Contact information
Practice address
205 BEDFORD ST, SUITE L, HAMILTON, MT 59840-2853
(406) 375-6670
(406) 375-6680
Mailing address
205 BEDFORD ST, SUITE L, HAMILTON, MT 59840-2853
(406) 375-6670
(406) 375-6680
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
MS0194958
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13561
BLUE CROSS BLUE SHIELD
MT
01
—
31388
BCBS IZ'S
MT
05
—
350-0952
—
MT
01
—
94450094
MBCHP
MT
Enumeration date
08/02/2006
Last updated
03/12/2008
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