Provider Demographics
NPI:1134564255
Name:ST VINCENT HEALTHCARE
Entity type:Organization
Organization Name:ST VINCENT HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:M
Authorized Official - Last Name:LOVELESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-237-3071
Mailing Address - Street 1:500 ELDORADO BLVD
Mailing Address - Street 2:BLDG 6 STE 6300
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80021-3408
Mailing Address - Country:US
Mailing Address - Phone:303-813-5300
Mailing Address - Fax:303-689-6678
Practice Address - Street 1:1233 N 30TH ST
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-0127
Practice Address - Country:US
Practice Address - Phone:406-237-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SISTERS OF CHARITY LEAVENWORTH HEALTH SYSTEM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-05-02
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT13258273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT27T049Medicare Oscar/Certification