Provider Demographics
NPI:1023066453
Name:COMMUNITY HOSPITAL OF ANACONDA
Entity type:Organization
Organization Name:COMMUNITY HOSPITAL OF ANACONDA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DEPARTMENT DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:KAASCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-563-8667
Mailing Address - Street 1:305 W PENNSYLVANIA ST
Mailing Address - Street 2:
Mailing Address - City:ANACONDA
Mailing Address - State:MT
Mailing Address - Zip Code:59711-1900
Mailing Address - Country:US
Mailing Address - Phone:406-563-8667
Mailing Address - Fax:406-563-8665
Practice Address - Street 1:305 W PENNSYLVANIA ST
Practice Address - Street 2:
Practice Address - City:ANACONDA
Practice Address - State:MT
Practice Address - Zip Code:59711-1900
Practice Address - Country:US
Practice Address - Phone:406-563-8667
Practice Address - Fax:406-563-8665
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMMUNITY HOSPITAL OF ANACONDA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-05
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT10062251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT00750087Medicaid
MT00750087Medicaid