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General NPI Number Information
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NPI Number | 1740223882
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Entity Type | Organization
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Legal Business Name | MADISON VALLEY HOSPITAL INC
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Dates
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Enumeration Date | 06/14/2006
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 305 N MAIN ST
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City | ENNIS
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State | MT
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Zip | 59729-9998
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Country | US
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Telephone | 406-682-6862
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Fax | 406-682-4756
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Provider Business Mailing Address
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Address Line | 305 N MAIN ST
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City | ENNIS
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State | MT
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Zip | 59729-9998
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Country | US
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Telephone | 406-682-6862
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Fax | 406-682-4756
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Authorized Official
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Title or Position | CFO
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Name | ALICIA NICHOLSON
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Credential |
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Telephone | 406-682-6626
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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 |
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License Number State |
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