Healthcare Provider Details

I. General information

NPI: 1205887924
Provider Name (Legal Business Name): COMMUNITY HOSPITAL OF ANACONDA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2006
Last Update Date: 11/14/2023
Certification Date: 11/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 W PENNSYLVANIA ST
ANACONDA MT
59711-1931
US

IV. Provider business mailing address

401 W PENNSYLVANIA ST
ANACONDA MT
59711-1931
US

V. Phone/Fax

Practice location:
  • Phone: 406-563-8500
  • Fax: 406-563-8565
Mailing address:
  • Phone: 406-563-8500
  • Fax: 406-563-8565

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QC0050X
TaxonomyCritical Access Hospital Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number12768
License Number StateMT
# 4
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number StateNULL
# 6
Primary TaxonomyN
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name: MRS. MARGARET I HICKEY-BOYNTON
Title or Position: CFO
Credential:
Phone: 406-563-8500