Provider Demographics
NPI:1346337664
Name:MARCUS DALY MEMORIAL HOSPITAL CORPORATION
Entity Type:Organization
Organization Name:MARCUS DALY MEMORIAL HOSPITAL CORPORATION
Other - Org Name:BITTERROOT HEALTH - STEVENSVILLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:C
Authorized Official - Last Name:BISHOP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-363-2211
Mailing Address - Street 1:1224 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:MT
Mailing Address - Zip Code:59840-2338
Mailing Address - Country:US
Mailing Address - Phone:406-375-4836
Mailing Address - Fax:406-375-4458
Practice Address - Street 1:3975 US HIGHWAY 93 N
Practice Address - Street 2:
Practice Address - City:STEVENSVILLE
Practice Address - State:MT
Practice Address - Zip Code:59870
Practice Address - Country:US
Practice Address - Phone:406-777-6002
Practice Address - Fax:406-206-2965
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID1346337664Medicaid
MT1346337664Medicaid
ID1346337664Medicaid
MT273420Medicare Oscar/Certification
MT273420 RURAL HEALTHMedicare PIN