Provider Demographics
NPI:1831138593
Name:NORTHERN ROCKIES MEDICAL CENTER, INC
Entity Type:Organization
Organization Name:NORTHERN ROCKIES MEDICAL CENTER, INC
Other - Org Name:LOGAN HEALTH - CUT BANK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHERIE
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-873-2251
Mailing Address - Street 1:802 2ND ST SE
Mailing Address - Street 2:
Mailing Address - City:CUT BANK
Mailing Address - State:MT
Mailing Address - Zip Code:59427-3329
Mailing Address - Country:US
Mailing Address - Phone:406-873-2251
Mailing Address - Fax:
Practice Address - Street 1:802 2ND ST SE
Practice Address - Street 2:
Practice Address - City:CUT BANK
Practice Address - State:MT
Practice Address - Zip Code:59427-3329
Practice Address - Country:US
Practice Address - Phone:406-873-2251
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-06
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT10272275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT3100307Medicaid
MT27Z337Medicare Oscar/Certification
MTCH9943Medicare PIN