Provider Demographics
NPI:1497002059
Name:ST. VINCENT HEALTHCARE
Entity Type:Organization
Organization Name:ST. VINCENT HEALTHCARE
Other - Org Name:ST. VINCENT PHYSICIAN NETWORK , LONG TERM CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
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 1:1101 N 27TH ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-0101
Mailing Address - Country:US
Mailing Address - Phone:406-237-8282
Mailing Address - Fax:406-237-8285
Practice Address - Street 1:1101 N 27TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-0101
Practice Address - Country:US
Practice Address - Phone:406-237-8282
Practice Address - Fax:406-237-8285
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-13
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT12129261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT4062378282OtherPHONE NUMBER