Provider Demographics
NPI:1164617031
Name:ROSEBUD COMMUNITY HOSPITAL INC
Entity Type:Organization
Organization Name:ROSEBUD COMMUNITY HOSPITAL INC
Other - Org Name:ROSEBUD MEDICAL CENTER RURAL HEALTH CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-346-4259
Mailing Address - Street 1:BOX 268
Mailing Address - Street 2:
Mailing Address - City:FORSYTH
Mailing Address - State:MT
Mailing Address - Zip Code:59327-0268
Mailing Address - Country:US
Mailing Address - Phone:406-346-2161
Mailing Address - Fax:406-346-4247
Practice Address - Street 1:383 NORTH 17TH AVE
Practice Address - Street 2:
Practice Address - City:FORSYTH
Practice Address - State:MT
Practice Address - Zip Code:59327-0268
Practice Address - Country:US
Practice Address - Phone:406-346-2161
Practice Address - Fax:406-349-4247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-13
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT273413Medicare Oscar/Certification