Provider Demographics
NPI:1265507172
Name:WHEATLAND MEMORIAL HEALTHCARE
Entity type:Organization
Organization Name:WHEATLAND MEMORIAL HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:NESTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-632-3115
Mailing Address - Street 1:PO BOX 287
Mailing Address - Street 2:
Mailing Address - City:HARLOWTON
Mailing Address - State:MT
Mailing Address - Zip Code:59036-0287
Mailing Address - Country:US
Mailing Address - Phone:406-632-4351
Mailing Address - Fax:406-632-3172
Practice Address - Street 1:530 3RD ST NW
Practice Address - Street 2:
Practice Address - City:HARLOWTON
Practice Address - State:MT
Practice Address - Zip Code:59036
Practice Address - Country:US
Practice Address - Phone:406-632-4351
Practice Address - Fax:406-632-3172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-24
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT10879275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0720278Medicaid
MT3100565Medicaid
MT0412488Medicaid
MT273986Medicare ID - Type UnspecifiedMEDICARE CLINIC
MT3100565Medicaid
MT27Z321Medicare Oscar/Certification