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General NPI Number Information
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NPI Number | 1962428706
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Entity Type | Organization
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Legal Business Name | SHERIDAN MEMORIAL HOSPITAL ASSOCIATION
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Dates
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Enumeration Date | 07/14/2006
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Last Update Date | 06/07/2016
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Provider Practice Location Address
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Address Line | 440 W LAUREL AVE
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City | PLENTYWOOD
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State | MT
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Zip | 59254-1526
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Country | US
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Telephone | 406-765-3700
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Fax | 406-765-3800
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Provider Business Mailing Address
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Address Line | 440 W LAUREL AVE
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City | PLENTYWOOD
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State | MT
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Zip | 59254-1526
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Country | US
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Telephone | 406-765-3700
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Fax | 406-765-3800
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Authorized Official
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Title or Position | CEO
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Name | WAYNE J NELSON
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Credential |
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Telephone | 406-765-3700
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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 | 10179
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License Number State | MT
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