PROVIDENCE ST JOSEPH MEDICAL CENTER NPI 1609104165

NPI Information

PROVIDENCE ST JOSEPH MEDICAL CENTER is a rural health clinic center in Polson, MT. PROVIDENCE ST JOSEPH MEDICAL CENTER NPI is 1609104165. The provider is registered as an organization entity type.
The provider Is Doing Business As Prov St Joseph Med Ctr Polson.

The provider's business location address is:

6 13TH AVE E
POLSON, MT
ZIP 59860-315
Phone: (406) 883-5680
Fax: (406) 883-8926

The provider's authorized official is Donald Wayne Anderson .
The authorized official title is Asst Sec For Enrollment/dir Reimb S and has the following contact phone number (425) 525-5392.

The CLIA number assigned to this NPI record is 27D0411066 - rural health clinic with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 11/20/2009 and was last updated on 10/29/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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