Provider Demographics
NPI:1659368512
Name:TOOLE COUNTY
Entity Type:Organization
Organization Name:TOOLE COUNTY
Other - Org Name:MARIAS MEDICAL CENTER CAH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EMS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PHIL
Authorized Official - Middle Name:O
Authorized Official - Last Name:ASCHIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-450-7040
Mailing Address - Street 1:825 OILFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:SHELBY
Mailing Address - State:MT
Mailing Address - Zip Code:59474-1642
Mailing Address - Country:US
Mailing Address - Phone:406-434-3200
Mailing Address - Fax:
Practice Address - Street 1:825 OILFIELD AVE
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:MT
Practice Address - Zip Code:59474-1642
Practice Address - Country:US
Practice Address - Phone:406-434-3200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOOLE COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-10-05
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3416L0300X
MT0303416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0446212Medicaid
MT0446212Medicaid