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General NPI Number Information
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NPI Number | 1336213446
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Entity Type | Organization
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Legal Business Name | ST LUKES COMMUNITY HOSPITAL
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Dates
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Enumeration Date | 11/20/2006
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | 107 6TH AVE SW
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City | RONAN
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State | MT
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Zip | 59864-2634
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Country | US
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Telephone | 406-676-4441
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Fax | 406-676-0835
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Provider Business Mailing Address
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Address Line | 107 6TH AVE SW
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City | RONAN
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State | MT
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Zip | 59864-2634
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Country | US
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Telephone | 406-676-4441
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Fax | 406-676-0835
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. SHANE H ROBERTS
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Credential |
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Telephone | 406-676-4441
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 275N00000X
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Taxonomy Name | Medicare Defined Swing Bed Hospital Unit
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | 10834
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License Number State | MT
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