Healthcare Provider Details

I. General information

NPI: 1285654483
Provider Name (Legal Business Name): GARFIELD COUNTY HEALTH CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

332 LEAVITT AVE
JORDAN MT
59337
US

IV. Provider business mailing address

332 LEAVITT AVE P.O. BOX 389
JORDAN MT
59337
US

V. Phone/Fax

Practice location:
  • Phone: 406-557-2500
  • Fax: 406-557-2950
Mailing address:
  • Phone: 406-557-2500
  • Fax: 406-557-2950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number10731
License Number StateMT

VIII. Authorized Official

Name: WANDA A HAGEMAN
Title or Position: ADMINISTRATOR
Credential:
Phone: 406-557-2500