MEDICARE: COMMUNITY MEDICAL CENTER INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

General Provider Information

NPI Number	:	1346333234
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY MEDICAL CENTER INC

Provider Business Mailing Address
First Line	:	PO BOX 16900
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59808-6900
Country	:	US
Telephone Number	:	406-777-2775
Fax Number	:

Provider Business Practice Location Address
First Line	:	3800 EASTSIDE HWY
Second Line	:
City	:	STEVENSVILLE
State	:	MT
Zip	:	59870-2224
Country	:	US
Telephone Number	:	406-777-2775
Fax Number	:

Authorized Official
Title or Position	:	VP PHYSICIAN SERVICES
Name	:	CYNTHIA WHITE
Credential	:
Telephone Number	:	406-327-4294

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	08/22/2020

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