# GLENDIVE MEDICAL CENTER, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1700896941
- **Authorized official:** WILLIAM ROBINSON (VP OF FINANCIAL SERVICES)
- **Authorized official phone:** (406) 345-3301

## Contact information

- **Practice address:** 202 PROSPECT DR, GLENDIVE, MT 59330-1943
- **Practice address phone:** (406) 345-3306
- **Practice address fax:** (406) 345-3358
- **Mailing address:** 202 PROSPECT DR, GLENDIVE, MT 59330-1943
- **Mailing address phone:** (406) 345-3306
- **Mailing address fax:** (406) 345-3358

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 10704 | MT | Yes |

## Other

- **Enumeration date:** 08/09/2006
- **Last updated:** 03/04/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0000316615 | — | MT |
| 01 | — | 000082 | SKILLED NURSING FACILITY | MT |