Provider Demographics
| NPI: | 1083602205 |
|---|---|
| Name: | BENEFIS COMMUNITY HOSPITALS, INC. |
| Entity Type: | Organization |
| Organization Name: | BENEFIS COMMUNITY HOSPITALS, INC. |
| Other - Org Name: | BENEFIS TETON MEDICAL CENTER |
| Other - Org Type: | Doing Business As |
| Authorized Official - Title/Position: | PRESIDENT |
| Authorized Official - Prefix: | MR |
| Authorized Official - First Name: | LOUIE |
| Authorized Official - Middle Name: | W |
| Authorized Official - Last Name: | KING |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 406-466-6001 |
| Mailing Address - Street 1: | 915 4TH ST NW |
| Mailing Address - Street 2: | |
| Mailing Address - City: | CHOTEAU |
| Mailing Address - State: | MT |
| Mailing Address - Zip Code: | 59422-9123 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 406-466-5763 |
| Mailing Address - Fax: | 406-466-5852 |
| Practice Address - Street 1: | 915 4TH ST NW |
| Practice Address - Street 2: | |
| Practice Address - City: | CHOTEAU |
| Practice Address - State: | MT |
| Practice Address - Zip Code: | 59422-9123 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 406-466-5763 |
| Practice Address - Fax: | 406-466-5852 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2005-10-11 |
| Last Update Date: | 2023-09-22 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| MT | 207P00000X, 207Q00000X, 225X00000X, 235Z00000X, 261QE0002X, 261QP2000X, 261QR0200X, 261QR1300X | |
| MT | 186726 | 261QR0207X |
| MT | 11016 | 275N00000X |
| MT | 9739 | 282NC0060X |
| MT | 27D0042064 | 291U00000X |
| MT | 10305 | 311ZA0620X |
| MT | 10075 | 314000000X |
| MT | 668 | 3336I0012X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 282NC0060X | Hospitals | General Acute Care Hospital | Critical Access | Group - Single Specialty |
| No | 207P00000X | Allopathic & Osteopathic Physicians | Emergency Medicine | Group - Single Specialty | |
| No | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Single Specialty | |
| No | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Single Specialty | |
| No | 235Z00000X | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | Group - Single Specialty | |
| No | 261QE0002X | Ambulatory Health Care Facilities | Clinic/Center | Emergency Care | Group - Single Specialty |
| No | 261QP2000X | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy | |
| No | 261QR0200X | Ambulatory Health Care Facilities | Clinic/Center | Radiology | |
| No | 261QR0207X | Ambulatory Health Care Facilities | Clinic/Center | Radiology, Mobile Mammography | |
| No | 261QR1300X | Ambulatory Health Care Facilities | Clinic/Center | Rural Health | |
| No | 275N00000X | Hospital Units | Medicare Defined Swing Bed Unit | Group - Single Specialty | |
| No | 291U00000X | Laboratories | Clinical Medical Laboratory | Group - Single Specialty | |
| No | 311ZA0620X | Nursing & Custodial Care Facilities | Custodial Care Facility | Adult Care Home | |
| No | 314000000X | Nursing & Custodial Care Facilities | Skilled Nursing Facility | Group - Single Specialty | |
| No | 3336I0012X | Suppliers | Pharmacy | Institutional Pharmacy |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| MT | 3100357 | Medicaid | |
| MT | 4108143 | Medicaid | |
| MT | 311597 | Medicaid | |
| MT | 271307 | Medicare Oscar/Certification | |
| MT | 27Z307 | Medicare Oscar/Certification | |
| MT | 4108143 | Medicaid | |
| MT | 275085 | Medicare ID - Type Unspecified | SNF/NF |
