Provider Demographics
NPI:1215059043
Name:CLARK FORK VALLEY HOSPITAL, INC
Entity type:Organization
Organization Name:CLARK FORK VALLEY HOSPITAL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:MURL
Authorized Official - Last Name:NEWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:406-826-4802
Mailing Address - Street 1:PO BOX 768
Mailing Address - Street 2:
Mailing Address - City:PLAINS
Mailing Address - State:MT
Mailing Address - Zip Code:59859-0768
Mailing Address - Country:US
Mailing Address - Phone:406-826-4802
Mailing Address - Fax:406-826-4883
Practice Address - Street 1:10 KRUGER ROAD
Practice Address - Street 2:
Practice Address - City:PLAINS
Practice Address - State:MT
Practice Address - Zip Code:59859-0678
Practice Address - Country:US
Practice Address - Phone:406-826-4802
Practice Address - Fax:406-826-4883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT183282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access