1952812026 NPI number — BENEFIS HOSPITALS INC

Table of content: (NPI 1952812026)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952812026 NPI number — BENEFIS HOSPITALS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BENEFIS HOSPITALS INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
BENEFIS HOSPITALS HOME INFUSION
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1952812026
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/24/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 5005
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREAT FALLS
Provider Business Mailing Address State Name:
MT
Provider Business Mailing Address Postal Code:
59403-5005
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
406-455-2185
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
500 15TH AVE S STE 2
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREAT FALLS
Provider Business Practice Location Address State Name:
MT
Provider Business Practice Location Address Postal Code:
59405-4324
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
406-455-2185
Provider Business Practice Location Address Fax Number:
406-455-2179
Provider Enumeration Date:
10/17/2017

Additional Information

Authorized Official

Authorized Official Last Name:
EHLINGER
Authorized Official First Name:
FORREST
Authorized Official Middle Name:
G
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER, BENEFIS HO
Authorized Official Telephone Number:
406-455-5454

Provider Taxonomy Codes

  • Taxonomy code: 251F00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BP3500X , with the licence number: PHA-PHR-LIC-1325 , registered in the state of MT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 333600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336H0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0571251 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0573461 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0574124 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".




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