Provider Demographics
NPI:1265547939
Name:PLAINS HOSPITAL CORPORATION
Entity type:Organization
Organization Name:PLAINS HOSPITAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:E
Authorized Official - Last Name:LOGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-826-4813
Mailing Address - Street 1:PO BOX 768
Mailing Address - Street 2:
Mailing Address - City:PLAINS
Mailing Address - State:MT
Mailing Address - Zip Code:59859-0768
Mailing Address - Country:US
Mailing Address - Phone:406-826-4813
Mailing Address - Fax:406-826-4811
Practice Address - Street 1:10 KRUGER ROAD
Practice Address - Street 2:
Practice Address - City:PLAINS
Practice Address - State:MT
Practice Address - Zip Code:59859
Practice Address - Country:US
Practice Address - Phone:406-826-4813
Practice Address - Fax:406-826-4811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT10608282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT412590Medicaid
MT60742OtherBLUE CROSS/MONTANA
MT94155OtherBLUE CROSS/MONTANA
MT412590Medicaid
MT000080331Medicare PIN
MT271323Medicare Oscar/Certification