Healthcare Provider Details

I. General information

NPI: 1205801172
Provider Name (Legal Business Name): COLSTRIP MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2006
Last Update Date: 12/26/2023
Certification Date: 12/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6230 MAIN STREET
COLSTRIP MT
59323-1858
US

IV. Provider business mailing address

6230 MAIN STREET
COLSTRIP MT
59323-1858
US

V. Phone/Fax

Practice location:
  • Phone: 406-748-3600
  • Fax: 406-748-3606
Mailing address:
  • Phone: 406-748-3600
  • Fax: 406-748-3606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateMT
# 2
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN POOLE
Title or Position: CLINIC MANAGER
Credential:
Phone: 406-748-3600