Healthcare Provider Details

I. General information

NPI: 1962396903
Provider Name (Legal Business Name): GLACIER COMMUNITY HEALTH CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2025
Last Update Date: 12/04/2025
Certification Date: 06/04/2025
Deactivation Date: 10/02/2025
Reactivation Date: 12/04/2025

III. Provider practice location address

519 E MAIN ST
CUT BANK MT
59427-3015
US

IV. Provider business mailing address

519 E MAIN ST
CUT BANK MT
59427-3015
US

V. Phone/Fax

Practice location:
  • Phone: 406-873-5670
  • Fax:
Mailing address:
  • Phone: 406-873-5670
  • Fax: 406-873-0156

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH SEGLEM
Title or Position: CEO
Credential:
Phone: 406-873-5670