Provider Demographics
NPI:1801065396
Name:DAHL MEMORIAL HEALTHCARE ASSOCIATION INC
Entity type:Organization
Organization Name:DAHL MEMORIAL HEALTHCARE ASSOCIATION INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TOOKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-775-8739
Mailing Address - Street 1:PO BOX 46
Mailing Address - Street 2:
Mailing Address - City:EKALAKA
Mailing Address - State:MT
Mailing Address - Zip Code:59324-0046
Mailing Address - Country:US
Mailing Address - Phone:406-775-8738
Mailing Address - Fax:406-775-6479
Practice Address - Street 1:106 E PARK ST
Practice Address - Street 2:
Practice Address - City:EKALAKA
Practice Address - State:MT
Practice Address - Zip Code:59324-0046
Practice Address - Country:US
Practice Address - Phone:406-775-8730
Practice Address - Fax:406-775-6479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-28
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC0050XAmbulatory Health Care FacilitiesClinic/CenterCritical Access Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTM000009920Medicare PIN