Healthcare Provider Details

I. General information

NPI: 1043266356
Provider Name (Legal Business Name): FRANCES MAHON DEACONESS HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 02/06/2024
Certification Date: 02/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 5TH AVE S
GLASGOW MT
59230-2600
US

IV. Provider business mailing address

221 5TH AVE S
GLASGOW MT
59230-2600
US

V. Phone/Fax

Practice location:
  • Phone: 406-228-3400
  • Fax:
Mailing address:
  • Phone: 406-228-3400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number10542
License Number StateMT
# 2
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CONNIE BRUNELLE
Title or Position: DIRECTOR OF PHYSICIAN RECRUITMENT
Credential:
Phone: 406-228-3609