Provider Demographics
NPI:1205038379
Name:PHILLIPS COUNTY HOSPITAL ASSN
Entity Type:Organization
Organization Name:PHILLIPS COUNTY HOSPITAL ASSN
Other - Org Name:PHILLIPS COUNTY FAMILY HEALTH CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:STEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:DENHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-654-1800
Mailing Address - Street 1:315 STH 8TH AVE E
Mailing Address - Street 2:
Mailing Address - City:MALTA
Mailing Address - State:MT
Mailing Address - Zip Code:59538
Mailing Address - Country:US
Mailing Address - Phone:406-654-1800
Mailing Address - Fax:406-654-1700
Practice Address - Street 1:315 STH 8TH AVE E
Practice Address - Street 2:
Practice Address - City:MALTA
Practice Address - State:MT
Practice Address - Zip Code:59538
Practice Address - Country:US
Practice Address - Phone:406-654-1800
Practice Address - Fax:406-654-1700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-01
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT273987Medicare Oscar/Certification