# PROVIDENCE ST JOSEPH MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PROVIDENCE HEALTH & SERVICES
- **Other names:** Prov St Joseph Med Ctr Polson
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1609104165
- **Legal business name:** PROVIDENCE HEALTH & SERVICES
- **Authorized official:** DONALD WAYNE ANDERSON JR. (ASSISTANT SECRETARY ENROLLMENTS)
- **Authorized official phone:** (425) 358-9786

## Contact information

- **Practice address:** 6 13TH AVE E, POLSON, MT 59860-5315
- **Practice address phone:** (406) 883-5680
- **Practice address fax:** (406) 883-8926
- **Mailing address:** PO BOX 31001-4110, PASADENA, CA 91110-4110

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 11/20/2009
- **Last updated:** 05/07/2025