1306236906 NPI number — LOGAN HEALTH - WHITEFISH

Table of content: (NPI 1306236906)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306236906 NPI number — LOGAN HEALTH - WHITEFISH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LOGAN HEALTH - WHITEFISH
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
NORTH VALLEY HOSPITAL, INC.
Provider Other Organization Name Type Code:
4
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1306236906
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/11/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1600 HOSPITAL WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WHITEFISH
Provider Business Mailing Address State Name:
MT
Provider Business Mailing Address Postal Code:
59937-7849
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
406-863-3510
Provider Business Mailing Address Fax Number:
406-863-3682

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1600 HOSPITAL WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WHITEFISH
Provider Business Practice Location Address State Name:
MT
Provider Business Practice Location Address Postal Code:
59937
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
406-863-3510
Provider Business Practice Location Address Fax Number:
406-863-3682
Provider Enumeration Date:
02/03/2015

Additional Information

Authorized Official

Authorized Official Last Name:
ABEL
Authorized Official First Name:
KEVIN
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
406-863-3500

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  PHA-PHI-LIC-1214 , registered in the state of MT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 282NC0060X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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