Healthcare Provider Details

I. General information

NPI: 1669639134
Provider Name (Legal Business Name): SAINT PATRICK HOSPITAL AND HEALTH SCIENCES CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2008
Last Update Date: 05/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 SANSOME ST
PHILIPSBURG MT
59858
US

IV. Provider business mailing address

500 W BROADWAY ST STE 320
MISSOULA MT
59802-4003
US

V. Phone/Fax

Practice location:
  • Phone: 406-329-5615
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. JIM GILLHOUSE
Title or Position: PRACTICE MANAGER
Credential:
Phone: 406-329-5615