Provider Demographics
NPI:1164464582
Name:BENEFIS HOSPITALS, INC.
Entity Type:Organization
Organization Name:BENEFIS HOSPITALS, INC.
Other - Org Name:BENEFIS AMBULATORY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO/VP
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:A
Authorized Official - Last Name:BALLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-455-5000
Mailing Address - Street 1:PO BOX 5096
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59403-5096
Mailing Address - Country:US
Mailing Address - Phone:406-455-5000
Mailing Address - Fax:
Practice Address - Street 1:500 15TH AVE S
Practice Address - Street 2:STE. 2
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-4304
Practice Address - Country:US
Practice Address - Phone:406-455-2170
Practice Address - Fax:406-455-2171
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BENEFIS HEALTH SYSTEM, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-11
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT13253336I0012X, 3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336I0012XSuppliersPharmacyInstitutional Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2705602OtherNCPDP/NABP
MT1164464582Medicaid