Provider Demographics
NPI: | 1083602205 |
---|---|
Name: | BENEFIS COMMUNITY HOSPITALS, INC. |
Entity type: | Organization |
Organization Name: | BENEFIS COMMUNITY HOSPITALS, INC. |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | SVP/CFO |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | BRUCE |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | HOULIHAN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 406-455-5000 |
Mailing Address - Street 1: | 915 4TH ST NW |
Mailing Address - Street 2: | |
Mailing Address - City: | CHOTEAU |
Mailing Address - State: | MT |
Mailing Address - Zip Code: | 59422-9123 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 406-466-5763 |
Mailing Address - Fax: | 406-466-5852 |
Practice Address - Street 1: | 915 4TH ST NW |
Practice Address - Street 2: | |
Practice Address - City: | CHOTEAU |
Practice Address - State: | MT |
Practice Address - Zip Code: | 59422-9123 |
Practice Address - Country: | US |
Practice Address - Phone: | 406-466-5763 |
Practice Address - Fax: | 406-466-5852 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2005-10-11 |
Last Update Date: | 2025-03-27 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
MT | 207P00000X, 207Q00000X, 225X00000X, 235Z00000X, 261QP2000X, 261QR0200X, 261QR1300X | |
261QM1300X | ||
MT | 186726 | 261QR0207X |
MT | 11016 | 275N00000X |
MT | 27D0042064 | 291U00000X |
MT | 10305 | 311ZA0620X |
MT | 10075 | 314000000X |
MT | 668 | 3336I0012X |
MT | 9739 | 282NC0060X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 282NC0060X | Hospitals | General Acute Care Hospital | Critical Access | |
No | 207P00000X | Allopathic & Osteopathic Physicians | Emergency Medicine | Group - Single Specialty | |
No | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Single Specialty | |
No | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Single Specialty | |
No | 235Z00000X | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | Group - Single Specialty | |
No | 261QM1300X | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty | Group - Single Specialty |
No | 261QP2000X | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy | |
No | 261QR0200X | Ambulatory Health Care Facilities | Clinic/Center | Radiology | |
No | 261QR0207X | Ambulatory Health Care Facilities | Clinic/Center | Radiology, Mobile Mammography | |
No | 261QR1300X | Ambulatory Health Care Facilities | Clinic/Center | Rural Health | |
No | 275N00000X | Hospital Units | Medicare Defined Swing Bed Unit | Group - Single Specialty | |
No | 291U00000X | Laboratories | Clinical Medical Laboratory | Group - Single Specialty | |
No | 311ZA0620X | Nursing & Custodial Care Facilities | Custodial Care Facility | Adult Care Home | Group - Single Specialty |
No | 314000000X | Nursing & Custodial Care Facilities | Skilled Nursing Facility | ||
No | 3336I0012X | Suppliers | Pharmacy | Institutional Pharmacy | Group - Single Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
MT | 3100357 | Medicaid | |
MT | 311597 | Medicaid | |
MT | 4108143 | Medicaid | |
MT | 271307 | Medicare Oscar/Certification | |
MT | 27Z307 | Medicare Oscar/Certification | |
MT | 4108143 | Medicaid | |
MT | 275085 | Medicare ID - Type Unspecified | SNF/NF |