PROVIDENCE ST JOSEPH MEDICAL CENTER (NPI# 1992853881) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992853881 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE ST JOSEPH MEDICAL CENTER |
| Other Organization Name | PROV ST JOSEPH MED CTR SWB |
| Practice Address |
6 13th Ave E Polson MT 59860-5315 |
| Mailing Address |
Po Box 262 Liberty Lake WA 99019-0262 |
| Practice Telephone | 4068835377 |
| Practice Fax Number | 4068838488 |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2017-07-10 |
| Authorized Official Name | DONALD ANDERSON JR. (ASST CORP SEC FOR ENROLLMENT) |
| Authorized Official Telephone | 4255255392 |
| Is Organization Subpart | Y |
| Parent Organization Name | PROVIDENCE HEALTH & SERVICES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282NC0060X |
General Acute Care Hospital Specialization: Critical Access |
12513 | MT | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MT | PTAN | 27Z343 | 01 |
| Other Name | Type Code |
|---|---|
| Prov St Joseph Med Ctr SWB | 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 |
| 1609104165 | Providence St Joseph Medical Center | Clinic/Center | 6 13th Ave E, Polson, MT 59860-5315 | 2009-11-20 |
| 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 |
| 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 | 282NC0060X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| Specialization | Critical Access |
| Definition to come. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821184888 | Providence St Joseph Medical Center | General Acute Care Hospital | 6 13th Ave E, Polson, MT 59860-5315 | 2006-10-05 |
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|---|---|---|---|---|
| 1679941967 | Ruby Valley Hospital | General Acute Care Hospital | 220 E Crofoot Ln, Sheridan, MT 59749-7714 | 2015-09-03 |
| 1235302142 | Phs Indian Hospital | General Acute Care Hospital | 10110 South 7650 East Phs, Crow Northern Cheyenne Indian, Crow Agency, MT 59022 | 2008-04-11 |
| 1407076219 | Us Health Dept of Health & Human Services | General Acute Care Hospital | Pryor Gap Road, Pryor, MT 59066-0009 | 2007-04-26 |
| 1790803369 | Mccone County Health Center, Inc. | General Acute Care Hospital | 605 Sullivan Avenue, Circle, MT 59215 | 2007-03-26 |
| 1750410395 | U S Health Dept of Health & Human Services | General Acute Care Hospital | 418 Harding Street, Lodge Grass, MT 59050-0780 | 2007-03-02 |
| 1730216037 | Public Hospital District of Beaverhead County Db | General Acute Care Hospital | 30 Mt Hwy 91 South, Dillon, MT 59725-3597 | 2007-02-27 |
| 1548395197 | Mountainview Medical Center | General Acute Care Hospital | 16 West Main Street, White Sulphur Springs, MT 59645-0817 | 2007-02-23 |
| 1659433175 | Memorial Hospital Association | General Acute Care Hospital | 600 W 21st Street, Red Lodge, MT 59068-0590 | 2006-12-14 |
| 1144381054 | Memorial Hospital Association | General Acute Care Hospital | 600 West 21st Street, Red Lodge, MT 59068-0590 | 2006-12-13 |
| 1053488387 | Stillwater Hospital Association, Inc. | General Acute Care Hospital | 710 N 11th Street, Columbus, MT 59019-0959 | 2006-11-30 |
| 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.