Provider Demographics
NPI:1841275211
Name:HELENA SURGICENTER, LLC
Entity type:Organization
Organization Name:HELENA SURGICENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:L
Authorized Official - Last Name:HUBLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-457-4203
Mailing Address - Street 1:2440 WINNE AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-4905
Mailing Address - Country:US
Mailing Address - Phone:406-457-4200
Mailing Address - Fax:406-457-4220
Practice Address - Street 1:2440 WINNE AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-4905
Practice Address - Country:US
Practice Address - Phone:406-457-4200
Practice Address - Fax:406-457-4220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-08
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT10469261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT60402OtherBLUE CROSS AND BLUE SHIEL
MT96271003OtherMT. BREAST & CERV. HLTH P
WA0126583OtherWASHINGTON WC
WA7122104Medicaid
MT0000350353Medicaid
MTMSF0522205OtherMONTANA STATE FUND
MT=========001OtherEMPLOYEE BENEFIT MGMT SVC
MT=========-00OtherOHIO WC
WA7122104Medicaid