Provider Demographics
NPI:1790803369
Name:MCCONE COUNTY HEALTH CENTER, INC.
Entity Type:Organization
Organization Name:MCCONE COUNTY HEALTH CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSAAEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-485-3381
Mailing Address - Street 1:P. O. BOX 48
Mailing Address - Street 2:
Mailing Address - City:CIRCLE
Mailing Address - State:MT
Mailing Address - Zip Code:59215-0048
Mailing Address - Country:US
Mailing Address - Phone:406-485-3381
Mailing Address - Fax:406-485-3383
Practice Address - Street 1:605 SULLIVAN AVENUE
Practice Address - Street 2:
Practice Address - City:CIRCLE
Practice Address - State:MT
Practice Address - Zip Code:59215
Practice Address - Country:US
Practice Address - Phone:406-485-3381
Practice Address - Fax:406-485-3383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT10099282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0230685Medicaid
MT2703002OtherNAPB
MT31100136Medicaid
MT60012OtherCAH BCBS
MT4105218Medicaid
MT000090433OtherCLINIC BCBS
MT317369Medicaid
MT40252OtherNURSING HOME BCBS
MT0432874Medicaid
MT60012OtherCAH BCBS
MT40252OtherNURSING HOME BCBS
MT60012OtherCAH BCBS
MT4105218Medicaid
MT317369Medicaid
MT31100136Medicaid