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Organization

SUMMIT SURGERY CENTER LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. GEORGANN K HAEFFNER R.N. (ADMINISTRATOR)
(406) 496-3550
Entity
Organization

Contact information

Practice address
434 SOUTH CLARK ST., BUTTE, MT 59701-2836
(406) 496-3550
(406) 496-3575
Mailing address
434 SOUTH CLARK ST., BUTTE, MT 59701-2836
(406) 496-3550
(406) 496-3575

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0060582
BCBS OF MONTANA
MT
05
0351067
MT
01
0536068
TRICARE/CHAMPUS
MT
01
490004966
RAILROAD MEDICARE MT
MT
Enumeration date
10/02/2006
Last updated
09/30/2022
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