Healthcare Provider Details

I. General information

NPI: 1043446164
Provider Name (Legal Business Name): CHARLOTTE SMITH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2009
Last Update Date: 06/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

706 HOSPITAL CIRCLE
BROWNING MT
59417
US

IV. Provider business mailing address

706 HOSPITAL CIRCLE
BROWNING MT
59417
US

V. Phone/Fax

Practice location:
  • Phone: 406-338-6202
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NR1301X
TaxonomyRural Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: MISS CHARLOTTE SMITH
Title or Position: RN/URGENT CARE
Credential:
Phone: 903-577-9004