Organization
PROVIDENCE HEALTH & SERVICES MT
Active
Other names
PMG MT, PROVIDENCE MEDICAL GROUP MONTANA
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD W ANDERSON JR. (DIR REIMB REG STRAT/ASST SEC ENROLL)
(425) 358-9786
Entity
Organization
Contact information
Practice address
3075 N RESERVE ST STE Q, MISSOULA, MT 59808-1390
(406) 327-1850
Mailing address
PO BOX 31001 - 4114, PASADENA, CA 91110-4114
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
12/03/2021
Last updated
02/10/2026
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