Provider Demographics
NPI:1285816447
Name:ST. VINCENT HEALTHCARE
Entity Type:Organization
Organization Name:ST. VINCENT HEALTHCARE
Other - Org Name:ST. VINCENT MEDICAL SUPPLY & MOBILITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:L
Authorized Official - Last Name:BARKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-237-3070
Mailing Address - Street 1:1111 S HAYNES AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:MILES CITY
Mailing Address - State:MT
Mailing Address - Zip Code:59301-5749
Mailing Address - Country:US
Mailing Address - Phone:406-233-4240
Mailing Address - Fax:406-237-8905
Practice Address - Street 1:1111 S HAYNES AVE
Practice Address - Street 2:SUITE E
Practice Address - City:MILES CITY
Practice Address - State:MT
Practice Address - Zip Code:59301-5749
Practice Address - Country:US
Practice Address - Phone:406-233-4240
Practice Address - Fax:406-233-4249
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SISTERS OF CHARITY HEALTH SYSTEM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-11-29
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
0424290010Medicare NSC