Healthcare Provider Details

I. General information

NPI: 1922160431
Provider Name (Legal Business Name): STILLWATER HOSPITAL ASSOCIATION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 08/02/2023
Certification Date: 08/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44 WEST 4TH AVE. NORTH
COLUMBUS MT
59019-0959
US

IV. Provider business mailing address

PO BOX 959
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 Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number10664
License Number StateMT

VIII. Authorized Official

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