Provider Demographics
NPI:1508807058
Name:ST. VINCENT HEALTHCARE
Entity Type:Organization
Organization Name:ST. VINCENT HEALTHCARE
Other - Org Name:SVPN MULTIPLE SCLEROSIS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:C
Authorized Official - Last Name:KINNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-237-3061
Mailing Address - Street 1:1041 N 29TH ST
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-0700
Mailing Address - Country:US
Mailing Address - Phone:406-237-5577
Mailing Address - Fax:406-237-5575
Practice Address - Street 1:1041 N 29TH ST
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-0700
Practice Address - Country:US
Practice Address - Phone:406-237-5577
Practice Address - Fax:406-237-5575
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST. VINCENT HEALTHCARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-08
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT9717261Q00000X
261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT000084116Medicare PIN