Provider Demographics
NPI:1285203257
Name:ST. JOHN'S LUTHERAN HOSPITAL, INC
Entity Type:Organization
Organization Name:ST. JOHN'S LUTHERAN HOSPITAL, INC
Other - Org Name:CABINET PEAKS MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:LEONARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-283-7219
Mailing Address - Street 1:209 HEALTH PARK DR
Mailing Address - Street 2:
Mailing Address - City:LIBBY
Mailing Address - State:MT
Mailing Address - Zip Code:59923-2001
Mailing Address - Country:US
Mailing Address - Phone:406-283-7189
Mailing Address - Fax:406-293-2453
Practice Address - Street 1:209 HEALTH PARK DR
Practice Address - Street 2:
Practice Address - City:LIBBY
Practice Address - State:MT
Practice Address - Zip Code:59923-2001
Practice Address - Country:US
Practice Address - Phone:406-283-7189
Practice Address - Fax:406-293-2453
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-23
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy