PROVIDENCE ST JOSEPH MEDICAL CENTER (NPI# 1609104165) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609104165 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE ST JOSEPH MEDICAL CENTER |
| Other Organization Name | PROV ST JOSEPH MED CTR POLSON |
| Practice Address |
6 13th Ave E Polson MT 59860-5315 |
| Mailing Address |
Po Box 1010 Polson MT 59860-1010 |
| Practice Telephone | 4068835680 |
| Practice Fax Number | 4068838926 |
| Mailing Telephone | 4068835680 |
| Mailing Fax Number | 4068838926 |
| Enumeration Date | 2009-11-20 |
| Last Update Date | 2013-05-13 |
| Authorized Official Name | MR. BRUCE WHITFIELD (CFO WESTERN MONTANA REGION) |
| Authorized Official Telephone | 4063295868 |
| Is Organization Subpart | Y |
| Parent Organization Name | PROVIDENCE HEALTH & SERVICES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Prov St Joseph Med Ctr Polson | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730417452 | Providence St Joseph Medical Center | Clinic/Center | 63351 Us Highway 93 S, Ronan, MT 59864-2702 | 2009-11-19 |
| 1285796920 | Providence St Joseph Medical Center | Assisted Living Facility | 11 17th Ave E, Polson, MT 59860-4083 | 2006-12-15 |
| 1669655528 | Providence St Joseph Medical Center | Family Medicine | 6 13th Ave E, Polson, MT 59860-5315 | 2007-12-13 |
| 1548394836 | Providence St Joseph Medical Center | Clinic/Center | 6 13th Ave E, Polson, MT 59860-5315 | 2007-03-16 |
| 1992853881 | Providence St Joseph Medical Center | General Acute Care Hospital | 6 13th Ave E, Polson, MT 59860-5315 | 2007-01-08 |
| 1821184888 | Providence St Joseph Medical Center | General Acute Care Hospital | 6 13th Ave E, Polson, MT 59860-5315 | 2006-10-05 |
| Street Address |
6 13TH AVE E |
| City | POLSON |
| State | MT |
| Zip Code | 59860-5315 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588669576 | Kenneth L. Galewyrick | Emergency Medicine | 6 13th Ave E, Polson, MT 59860-5315 | 2005-06-16 |
| 1982227443 | Sarah Elizabeth Anderson | Pharmacist | 6 13th Ave E, Polson, MT 59860-5315 | 2020-05-19 |
| 1932601796 | Elizabeth Nicole Bassler | Social Worker | 6 13th Ave E, Polson, MT 59860-5315 | 2018-03-07 |
| 1437661113 | Paige J Stone | Pharmacist | 6 13th Ave E, Polson, MT 59860-5315 | 2017-11-02 |
| 1992230239 | Corey Gaul | Emergency Medicine | 6 13th Ave E, Polson, MT 59860-5315 | 2017-04-24 |
| 1235679796 | Shana Eaglefeathers | Family Medicine | 6 13th Ave E, Polson, MT 59860-5315 | 2017-03-03 |
| 1306296249 | Susan Weaselhead | Counselor | 6 13th Ave E, Polson, MT 59860-5315 | 2016-06-21 |
| 1194191569 | Clint Tjelmeland | Pharmacist | 6 13th Ave E, Polson, MT 59860-5315 | 2015-08-19 |
| 1134501117 | Maria Mcneil Williams | Nurse Practitioner | 6 13th Ave E, Polson, MT 59860-5315 | 2015-06-25 |
| 1831581669 | Angelia Relph | Nurse Anesthetist, Certified Registered | 6 13th Ave E, Polson, MT 59860-5315 | 2015-03-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679095020 | Ashley J Gilham | Registered Nurse | #5 4th Ave E., Polson, MT 59860 | 2017-07-07 |
| 1225585532 | St. Luke Community Hospital | Clinic/Center | 107 Ridgewater Dr., Polson, MT 59860 | 2016-09-02 |
| 1306202163 | Western Montana Mental Health Center | Community Based Residential Treatment Facility, Mental Illness | 7 13th Ave East, Polson, MT 59860 | 2016-01-11 |
| 1154730364 | Wanda L King | Dietitian, Registered | 6 Thirteenth Avenue East, Poslon, MT 59860 | 2014-08-13 |
| 1104255637 | Dacia Lee Antiste-fisher | Counselor | #5 4th Ave. E., Polson, MT 59860 | 2013-11-05 |
| 1154758134 | Richard Pierre | Pharmacy Technician | 5 4th Ave E., Polson, MT 59860 | 2013-10-04 |
| 1154755197 | Wal-mart Stores, Inc | Durable Medical Equipment & Medical Supplies | 36318 Memory Lane, Polson, MT 59860 | 2013-08-27 |
| 1245582022 | Catherine D Addison | Registered Nurse | 5 4th Ave. East, Polson, MT 59860 | 2012-10-04 |
| 1114220787 | Erika Ann Weber | Social Worker | #5 4th Ave. E, Polson, MT 59860 | 2010-12-21 |
| 1942431473 | Lisa L. Scalpane | Counselor | 803 Main Street, Suite C, Polson, MT 59860 | 2009-07-31 |
| Find all providers in zip 59860 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184785420 | St. Lukes Community Hospital | Clinic/Center | 104 Rufus Ln, Polson, MT 59860-8903 | 2006-12-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730434309 | Stillwater Hospital Association, Inc. | Clinic/Center | 710 N. 11th St., Box 959, Columbus, MT 59019-0959 | 2012-07-19 |
| 1730417452 | Providence St Joseph Medical Center | Clinic/Center | 63351 Us Highway 93 S, Ronan, MT 59864-2702 | 2009-11-19 |
| 1265605398 | Eastern Montana Health Company | Clinic/Center | 507 North Lincoln Ave, Box 489, Broadus, MT 59317-0489 | 2008-04-09 |
| 1073781548 | Great Falls Clinic | Clinic/Center | 124 Main Avenue North, Choteau, MT 59422-9410 | 2008-02-18 |
| 1205038379 | Phillips County Hospital Assn | Clinic/Center | 315 Sth 8th Ave E, Malta, MT 59538 | 2007-06-01 |
| 1942321120 | Granite County Hospital District | Clinic/Center | 26 East Broad St, Drummond, MT 59832-0312 | 2007-04-03 |
| 1851425789 | Three Rivers Clinic LLC | Clinic/Center | 16 Railway Ave, Three Forks, MT 59752-1078 | 2007-03-15 |
| 1750459632 | Daniels Memorial Hospital | Clinic/Center | 105 5th Ave. East, Scobey, MT 59263 | 2006-12-01 |
| 1003984097 | Liberty County Hospital and Nursing Home, Inc | Clinic/Center | 418 West Monroe Avenue, Chester, MT 59522-0506 | 2006-11-30 |
| 1730252883 | Sidney Health Center | Clinic/Center | 304 S Ellery, Fairview, MT 59221 | 2006-11-16 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.