Provider Demographics
NPI: | 1578254942 |
---|---|
Name: | BENEFIS HOSPITALS, INC. |
Entity Type: | Organization |
Organization Name: | BENEFIS HOSPITALS, INC. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CREDENTIALING COORDINATOR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | BETTY |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | COLE |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 406-455-2172 |
Mailing Address - Street 1: | PO BOX 5096 |
Mailing Address - Street 2: | |
Mailing Address - City: | GREAT FALLS |
Mailing Address - State: | MT |
Mailing Address - Zip Code: | 59403-5096 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 406-455-2170 |
Mailing Address - Fax: | 406-455-2171 |
Practice Address - Street 1: | 500 15TH AVE S STE 2 |
Practice Address - Street 2: | |
Practice Address - City: | GREAT FALLS |
Practice Address - State: | MT |
Practice Address - Zip Code: | 59405-4324 |
Practice Address - Country: | US |
Practice Address - Phone: | 406-455-2170 |
Practice Address - Fax: | 406-455-2171 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | BENEFIS HEALTH SYSTEM INC |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2023-05-17 |
Last Update Date: | 2023-06-29 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 3336C0003X | Suppliers | Pharmacy | Community/Retail Pharmacy |
No | 3336S0011X | Suppliers | Pharmacy | Specialty Pharmacy |