Provider Demographics
NPI:1760489272
Name:PRAIRIE COUNTY HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:PRAIRIE COUNTY HOSPITAL DISTRICT
Other - Org Name:PRAIRIE COMMUNITY HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:REED
Authorized Official - Middle Name:E
Authorized Official - Last Name:REYMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-635-5511
Mailing Address - Street 1:PO BOX 156
Mailing Address - Street 2:
Mailing Address - City:TERRY
Mailing Address - State:MT
Mailing Address - Zip Code:59349-0156
Mailing Address - Country:US
Mailing Address - Phone:406-635-5511
Mailing Address - Fax:406-635-5510
Practice Address - Street 1:312 SOUTH ADAMS AVENUE
Practice Address - Street 2:
Practice Address - City:TERRY
Practice Address - State:MT
Practice Address - Zip Code:59349-0156
Practice Address - Country:US
Practice Address - Phone:406-635-5511
Practice Address - Fax:406-635-5510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-30
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT10125282NC0060X
MT10124314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT4105777Medicaid
MT313456Medicaid
MT0720551Medicaid
MT27Z309Medicare Oscar/Certification
MT0720551Medicaid
MT271309Medicare Oscar/Certification
MT313456Medicaid