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Organization

PROVIDENCE ST JOSEPH MEDICAL CENTER

Active
Parent organization
PROVIDENCE HEALTH & SERVICES
Other names
Providence St Joseph Medical Center, Prov St Joseph Med Ctr SWB
Organization subpart
Yes

Provider details

NPI number
Legal business name
PROVIDENCE HEALTH & SERVICES
Authorized official
DONALD W ANDERSON JR. (ASSISTANT SECRETARY ENROLLMENT)
(425) 358-9786
Entity
Organization

Contact information

Practice address
6 13TH AVE E, POLSON, MT 59860-5315
(406) 883-5377
(406) 883-8488
Mailing address
PO BOX 31001-4110, PASADENA, CA 91110-4110

Taxonomy

Speciality
Code
Description
License number
State
275N00000X
Medicare Defined Swing Bed Hospital Unit
282NC0060X
Critical Access Hospital
Primary
12513
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
27Z343
PTAN
MT
Enumeration date
01/08/2007
Last updated
05/07/2025
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