Provider Demographics
NPI:1962627596
Name:ST. PATRICK HOSPITAL & HEALTH SCIENCES CENTER
Entity Type:Organization
Organization Name:ST. PATRICK HOSPITAL & HEALTH SCIENCES CENTER
Other - Org Name:OCCUPATIONAL HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCAFEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-329-5623
Mailing Address - Street 1:601 W SPRUCE ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59802-4057
Mailing Address - Country:US
Mailing Address - Phone:406-329-5746
Mailing Address - Fax:406-329-1697
Practice Address - Street 1:601 W SPRUCE ST
Practice Address - Street 2:SUITE C
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-4057
Practice Address - Country:US
Practice Address - Phone:406-329-5746
Practice Address - Fax:406-329-1697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTD96345Medicare UPIN