Provider Demographics
NPI:1750459632
Name:DANIELS MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:DANIELS MEMORIAL HOSPITAL
Other - Org Name:DANIELS MEMORIAL HOSPITAL ASSOCIATION
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:ALDRICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-487-2296
Mailing Address - Street 1:105 5TH AVE. EAST
Mailing Address - Street 2:
Mailing Address - City:SCOBEY
Mailing Address - State:MT
Mailing Address - Zip Code:59263
Mailing Address - Country:US
Mailing Address - Phone:406-487-2296
Mailing Address - Fax:
Practice Address - Street 1:105 5TH AVE. EAST
Practice Address - Street 2:
Practice Address - City:SCOBEY
Practice Address - State:MT
Practice Address - Zip Code:59263
Practice Address - Country:US
Practice Address - Phone:406-487-2296
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DANIELS MEMORIAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-01
Last Update Date:2017-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT000085097OtherMEDICARE GROUP HEALTH
MT720443Medicaid
MT011000344Medicare PIN
MT273998Medicare ID - Type Unspecified
MT720443Medicaid
011000398Medicare PIN