Healthcare Provider Details

I. General information

NPI: 1386719656
Provider Name (Legal Business Name): SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2006
Last Update Date: 05/01/2024
Certification Date: 05/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 S CRYSTAL ST STE 230
BUTTE MT
59701-1506
US

IV. Provider business mailing address

435 S CRYSTAL ST STE 230
BUTTE MT
59701-1506
US

V. Phone/Fax

Practice location:
  • Phone: 406-723-2441
  • Fax: 406-723-2799
Mailing address:
  • Phone: 406-723-2441
  • Fax: 406-723-2799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number1213
License Number StateMT
# 5
Primary TaxonomyY
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: CARRIE DUNFORD
Title or Position: CHIEF PHARMACY OFFICER
Credential:
Phone: 801-284-1004