Healthcare Provider Details

I. General information

NPI: 1598874232
Provider Name (Legal Business Name): CULBERTSON FROID BAINVILLE HEALTH CARE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 12/18/2019
Certification Date: 12/18/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

818 2ND AVE E
CULBERTSON MT
59218-9363
US

IV. Provider business mailing address

PO BOX 419
CULBERTSON MT
59218-0419
US

V. Phone/Fax

Practice location:
  • Phone: 406-787-6401
  • Fax: 406-787-6289
Mailing address:
  • Phone: 406-787-6401
  • Fax: 406-787-6461

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number10739
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number42
License Number StateMT
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateMT

VIII. Authorized Official

Name: AUDREY STROMBERG
Title or Position: ADMINISTRATOR
Credential:
Phone: 406-787-6401