Healthcare Provider Details

I. General information

NPI: 1316125677
Provider Name (Legal Business Name): ST LUKES COMMUNITY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2008
Last Update Date: 12/30/2024
Certification Date: 12/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 6TH AVE SW
RONAN MT
59864-2634
US

IV. Provider business mailing address

107 6TH AVE SW
RONAN MT
59864-2634
US

V. Phone/Fax

Practice location:
  • Phone: 406-676-4441
  • Fax: 406-676-0835
Mailing address:
  • Phone: 406-676-4441
  • Fax: 406-676-0835

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. STEVE J TODD
Title or Position: CEO
Credential:
Phone: 406-676-4441