Healthcare Provider Details
I. General information
NPI: 1275702987
Provider Name (Legal Business Name): ST PETER'S HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/27/2008
Last Update Date: 06/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2475 E BROADWAY ST
HELENA MT
59601-4928
US
IV. Provider business mailing address
2475 E BROADWAY ST
HELENA MT
59601-4928
US
V. Phone/Fax
- Phone: 406-444-2355
- Fax: 406-447-2407
- Phone: 406-444-2355
- Fax: 406-447-2407
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251F00000X |
| Taxonomy | Home Infusion Agency |
| License Number | 790 |
| License Number State | MT |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name: MR.
TOM
LITERSKI
Title or Position: PHARMACY DIRECTOR
Credential: RPH
Phone: 406-444-2355