Provider Demographics
NPI:1912208844
Name:ST PATRICKS HOSPITAL AND HEALTH SCIENCES CENTER
Entity Type:Organization
Organization Name:ST PATRICKS HOSPITAL AND HEALTH SCIENCES CENTER
Other - Org Name:IHI POLSON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:E
Authorized Official - Last Name:MCGUIRE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:406-329-5315
Mailing Address - Street 1:500 W BROADWAY ST
Mailing Address - Street 2:SUITE 320
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59802-4008
Mailing Address - Country:US
Mailing Address - Phone:406-541-7000
Mailing Address - Fax:406-541-7001
Practice Address - Street 1:104 RUFUS LN
Practice Address - Street 2:
Practice Address - City:POLSON
Practice Address - State:MT
Practice Address - Zip Code:59860-8903
Practice Address - Country:US
Practice Address - Phone:406-541-7000
Practice Address - Fax:406-541-7001
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST PATRICKS HOSPITAL AND HEALTH SCIENCES CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-11-09
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT=========Medicare PIN