Healthcare Provider Details

I. General information

NPI: 1053445148
Provider Name (Legal Business Name): CHOUTEAU COUNTY DISTRICT HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 03/12/2020
Certification Date: 03/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 SAINT CHARLES ST
FORT BENTON MT
59442-7710
US

IV. Provider business mailing address

PO BOX 249
FORT BENTON MT
59442-0249
US

V. Phone/Fax

Practice location:
  • Phone: 406-622-3331
  • Fax: 406-622-5670
Mailing address:
  • Phone: 406-622-3331
  • Fax: 406-622-5670

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number11052
License Number StateMT

VIII. Authorized Official

Name: MS. JANICE WOODHOUSE
Title or Position: COO
Credential:
Phone: 406-622-3331