Provider Demographics
NPI:1134297179
Name:INTERMOUNTAIN PLANNED PARENTHOOD INC
Entity type:Organization
Organization Name:INTERMOUNTAIN PLANNED PARENTHOOD INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL OPERATIONS COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:PREMO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-830-3482
Mailing Address - Street 1:1643 LEWIS AVE STE 211
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-4151
Mailing Address - Country:US
Mailing Address - Phone:406-248-3637
Mailing Address - Fax:406-254-9330
Practice Address - Street 1:1844 BROADWATER AVE SUITE 4
Practice Address - Street 2:(PPMT BILLINGS WEST)
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102
Practice Address - Country:US
Practice Address - Phone:406-656-9980
Practice Address - Fax:406-656-9928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning FacilityGroup - Multi-Specialty
No332900000XSuppliersNon-Pharmacy Dispensing SiteGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT332900000XOtherNON-PHARMACY DISPENSING
MT8806889Medicaid
MT8806889Medicaid