Healthcare Provider Details

I. General information

NPI: 1962536052
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: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 ST. CHARLES
FORT BENTON MT
59442
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 Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MS. STACY ANN BISEL
Title or Position: BUSINESS OFFICE MANAGER
Credential:
Phone: 406-622-6169