Provider Demographics
NPI:1558971986
Name:SCL HEALTH MEDICAL GROUP - BILLINGS, LLC
Entity Type:Organization
Organization Name:SCL HEALTH MEDICAL GROUP - BILLINGS, LLC
Other - Org Name:BROADWATER CLINIC - WALK - IN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP FINANCE MEDICAL GROUP
Authorized Official - Prefix:
Authorized Official - First Name:JON
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDANIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-272-0231
Mailing Address - Street 1:1233 N 30TH ST
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-0127
Mailing Address - Country:US
Mailing Address - Phone:406-237-7700
Mailing Address - Fax:
Practice Address - Street 1:2019 BROADWATER AVE
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-4810
Practice Address - Country:US
Practice Address - Phone:406-237-8550
Practice Address - Fax:406-237-8565
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-07-31
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty