Healthcare Provider Details

I. General information

NPI: 1730434309
Provider Name (Legal Business Name): STILLWATER HOSPITAL ASSOCIATION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2012
Last Update Date: 08/02/2023
Certification Date: 08/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 N. 11TH ST. BOX 959
COLUMBUS MT
59019-0959
US

IV. Provider business mailing address

710 N. 11TH ST.
COLUMBUS MT
59019-0959
US

V. Phone/Fax

Practice location:
  • Phone: 406-322-5316
  • Fax: 406-322-5207
Mailing address:
  • Phone: 406-322-5316
  • Fax: 406-322-5207

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. LUKE KOBOLD
Title or Position: CEO
Credential:
Phone: 406-322-1000