Provider Demographics
NPI:1992910822
Name:COMMUNITY HOSPITAL OF ANACONDA
Entity type:Organization
Organization Name:COMMUNITY HOSPITAL OF ANACONDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEPT DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:R
Authorized Official - Last Name:CORTRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-563-8528
Mailing Address - Street 1:401 W PENNSYLVANIA ST
Mailing Address - Street 2:
Mailing Address - City:ANACONDA
Mailing Address - State:MT
Mailing Address - Zip Code:59711-1931
Mailing Address - Country:US
Mailing Address - Phone:406-563-8528
Mailing Address - Fax:
Practice Address - Street 1:401 W PENNSYLVANIA ST
Practice Address - Street 2:
Practice Address - City:ANACONDA
Practice Address - State:MT
Practice Address - Zip Code:59711-1931
Practice Address - Country:US
Practice Address - Phone:406-563-8528
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT10923313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT27Z335Medicare Oscar/Certification