MEDICARE: ROUNDUP MEMORIAL HOSPITAL ASSOCIATION

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	282NC0060X	Critical Access Hospital	11708	MT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386751196
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROUNDUP MEMORIAL HOSPITAL ASSOCIATION

Provider Business Mailing Address
First Line	:	PO BOX 40
Second Line	:
City	:	ROUNDUP
State	:	MT
Zip	:	59072-0040
Country	:	US
Telephone Number	:	406-323-2301
Fax Number	:	406-323-3002

Provider Business Practice Location Address
First Line	:	1203 THIRD ST W
Second Line	:
City	:	ROUNDUP
State	:	MT
Zip	:	59072-0040
Country	:	US
Telephone Number	:	406-323-3201
Fax Number	:	406-323-3005

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	MRS. HOLLY WOLFF
Credential	:
Telephone Number	:	406-323-2301

Provider Enumeration Date	:	08/25/2006
Last Update Date	:	06/30/2020

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Directions to “ROUNDUP MEMORIAL HOSPITAL ASSOCIATION ” Practice Location

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