Provider Demographics
NPI:1477594950
Name:ST. VINCENT HEALTHCARE
Entity Type:Organization
Organization Name:ST. VINCENT HEALTHCARE
Other - Org Name:WORDEN CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:T
Authorized Official - Last Name:PAQUETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-237-3071
Mailing Address - Street 1:2469 MAIN STREET
Mailing Address - Street 2:P.O. BOX 246
Mailing Address - City:WORDEN
Mailing Address - State:MT
Mailing Address - Zip Code:59088-0246
Mailing Address - Country:US
Mailing Address - Phone:406-967-2255
Mailing Address - Fax:406-967-2251
Practice Address - Street 1:2469 MAIN STREET
Practice Address - Street 2:
Practice Address - City:WORDEN
Practice Address - State:MT
Practice Address - Zip Code:59088-0246
Practice Address - Country:US
Practice Address - Phone:406-967-2255
Practice Address - Fax:406-967-2251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT9717261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care