Provider Demographics
NPI:1518074061
Name:PLAINS HOSPITAL CORPORATION
Entity type:Organization
Organization Name:PLAINS HOSPITAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:S
Authorized Official - Last Name:HANSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:406-826-4814
Mailing Address - Street 1:10 KRUGER RD
Mailing Address - Street 2:PO BOX 768
Mailing Address - City:PLAINS
Mailing Address - State:MT
Mailing Address - Zip Code:59859-9506
Mailing Address - Country:US
Mailing Address - Phone:408-826-4921
Mailing Address - Fax:406-826-4811
Practice Address - Street 1:120 POND ST
Practice Address - Street 2:
Practice Address - City:THOMSPON FALLS
Practice Address - State:MT
Practice Address - Zip Code:59873
Practice Address - Country:US
Practice Address - Phone:406-826-4921
Practice Address - Fax:406-826-4811
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PLAINS HOSPITAL CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-23
Last Update Date:2016-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT10608261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0721006Medicaid
MT273979OtherMEDICARE ID
MT63202OtherBLUE CROSS/MT
MT0721006Medicaid