1326156019 NPI number — PLAINS HOSPITAL CORPORATION

Table of content: (NPI 1326156019)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326156019 NPI number — PLAINS HOSPITAL CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PLAINS HOSPITAL CORPORATION
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:
Provider Other Organization Name Type Code:
6
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:
1326156019
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/10/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10 KRUGER RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PLAINS
Provider Business Mailing Address State Name:
MT
Provider Business Mailing Address Postal Code:
59859-9506
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
406-826-4816
Provider Business Mailing Address Fax Number:
406-826-4898

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1029 HWY 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NOXON
Provider Business Practice Location Address State Name:
MT
Provider Business Practice Location Address Postal Code:
59853
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
406-826-4816
Provider Business Practice Location Address Fax Number:
406-826-4898
Provider Enumeration Date:
08/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HARRISON
Authorized Official First Name:
MARGO
Authorized Official Middle Name:
E
Authorized Official Title or Position:
PRESIDENT/CEO
Authorized Official Telephone Number:
406-826-4814

Provider Taxonomy Codes

  • Taxonomy code: 261QR1300X , with the licence number:  10608 , registered in the state of MT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 66512 . This is a "BLUE CROSS/MONTANA" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".
  • Identifier: 0722077 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".




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