Healthcare Provider Details

I. General information

NPI: 1396711396
Provider Name (Legal Business Name): COMMUNITY MEDICAL CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2006
Last Update Date: 09/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2827 FORT MISSOULA RD
MISSOULA MT
59804-7408
US

IV. Provider business mailing address

2827 FORT MISSOULA RD
MISSOULA MT
59804-7408
US

V. Phone/Fax

Practice location:
  • Phone: 406-728-4100
  • Fax:
Mailing address:
  • Phone: 406-728-4100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number10002
License Number StateMT

VIII. Authorized Official

Name: DAVID RICHHART
Title or Position: CFO
Credential: CFO
Phone: 406-728-4100