MEDICARE: PHILLIPS COUNTY HOSPITAL ASSN

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	251E00000X	Home Health Agency	10813	MT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	30061	OTHER	MT	BC BS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417091018
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHILLIPS COUNTY HOSPITAL ASSN

Provider Business Mailing Address
First Line	:	311 SOUTH 8TH AVE EAST
Second Line	:
City	:	MALTA
State	:	MT
Zip	:	59538
Country	:	US
Telephone Number	:	406-654-1100
Fax Number	:	406-654-2876

Provider Business Practice Location Address
First Line	:	311 SOUTH 8TH AVE EAST
Second Line	:
City	:	MALTA
State	:	MT
Zip	:	59538
Country	:	US
Telephone Number	:	406-654-1100
Fax Number	:	406-654-2876

Authorized Official
Title or Position	:	SUPERVISOR
Name	:	JANICE REICHELT
Credential	:	RN
Telephone Number	:	406-654-1100

Provider Enumeration Date	:	02/16/2007
Last Update Date	:	02/04/2010

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