Provider Demographics
NPI:1912936634
Name:ASHLAND COMMUNITY HEALTH CENTER
Entity type:Organization
Organization Name:ASHLAND COMMUNITY HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAAREN
Authorized Official - Middle Name:L
Authorized Official - Last Name:RIZOR
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:406-784-2346
Mailing Address - Street 1:PO BOX 47
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:MT
Mailing Address - Zip Code:59003-0047
Mailing Address - Country:US
Mailing Address - Phone:406-784-2346
Mailing Address - Fax:406-784-2711
Practice Address - Street 1:501 MAIN ST.
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:MT
Practice Address - Zip Code:59003-0047
Practice Address - Country:US
Practice Address - Phone:406-784-2346
Practice Address - Fax:406-784-2711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-03
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT9986905Medicaid
MT28024Medicare UPIN
MTF61685Medicare UPIN
MT27-1816Medicare ID - Type UnspecifiedFQHC MEDICARE NUMBER
MT9986905Medicaid