Organization · NPI-2

Origin Health LLC

Obstetrics & Gynecology, Maternal & Fetal Medicine · Missoula, MT

NPI number1841835113

StatusActive

Last updated in NPPESJun 23, 2020

Details

NPI: 1841835113
Entity type: Organization (NPI-2)
Legal business name: Origin Health LLC
Organization subpart: No
Enumeration date: Nov 11, 2019
Certification date: Jun 23, 2020
Last updated: Jun 23, 2020

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
207VM0101X	Obstetrics & Gynecology, Maternal & Fetal Medicine	–	–	Yes
207V00000X	Obstetrics & Gynecology	–	–
207VC0200X	Obstetrics & Gynecology, Critical Care Medicine	–	–
207VG0400X	Obstetrics & Gynecology, Gynecology	–	–
207VX0000X	Obstetrics & Gynecology, Obstetrics	–	–
2085U0001X	Radiology, Diagnostic Ultrasound	–	–
2471S1302X	Radiologic Technologist, Sonography	–	–

Practice location

2831 Fort Missoula Rd Ste 232
Missoula, MT 59804-7479

Phone 406-523-5650 · Fax 406-303-4041

Mailing address

2831 Fort Missoula Rd Ste 232
Missoula, MT 59804-7479

Phone 406-523-5650 · Fax 406-303-4041

Other practice locations

770 W Reserve Dr Ste 3
Kalispell, MT 59901-2158

Phone 406-751-3003 · Fax 406-607-6160

2600 Winne Ave Ste E
Helena, MT 59601-4900

Phone 406-558-2300 · Fax 406-430-0130

225 S Clark St
Butte, MT 59701-1515

Phone 406-221-1195 · Fax 406-792-1750

1400 29th St S Ste 101
Great Falls, MT 59405-5316

Phone 406-205-1999 · Fax 406-604-0300

Authorized official

Stephen G Loosli
Executive Director
2085579898

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