Healthcare Provider Details

I. General information

NPI: 1386751196
Provider Name (Legal Business Name): ROUNDUP MEMORIAL HOSPITAL ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2006
Last Update Date: 06/30/2020
Certification Date: 06/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1203 THIRD ST W
ROUNDUP MT
59072-0040
US

IV. Provider business mailing address

PO BOX 40
ROUNDUP MT
59072-0040
US

V. Phone/Fax

Practice location:
  • Phone: 406-323-3201
  • Fax: 406-323-3005
Mailing address:
  • Phone: 406-323-2301
  • Fax: 406-323-3002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number11708
License Number StateMT

VIII. Authorized Official

Name: MRS. HOLLY WOLFF
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 406-323-2301