Basic Information
Provider Information | |||||||||
NPI: | 1326042078 | ||||||||
EntityType: | 2 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: | BARRETT HOSPITAL DEVELOPMENT CORPORATION | ||||||||
LastName: |   | ||||||||
FirstName: |   | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: |   | ||||||||
OtherOrganizationName: | BARRETT HOSPITAL & HEALTHCARE | ||||||||
OtherOrganizationType: | 3 | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 600 MT HWY 91 SOUTH | ||||||||
Address2: |   | ||||||||
City: | DILLON | ||||||||
State: | MT | ||||||||
PostalCode: | 597253597 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 4066833000 | ||||||||
FaxNumber: | 4066833206 | ||||||||
Practice Location | |||||||||
Address1: | 600 MT HWY 91 SOUTH | ||||||||
Address2: |   | ||||||||
City: | DILLON | ||||||||
State: | MT | ||||||||
PostalCode: | 597253597 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 4066833000 | ||||||||
FaxNumber: | 4066833206 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 06/10/2005 | ||||||||
LastUpdateDate: | 01/19/2021 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: |   | ||||||||
AuthorizedOfficialLastName: | GIEM | ||||||||
AuthorizedOfficialFirstName: | TINA | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: | CHIEF FINANCIAL OFFICER | ||||||||
AuthorizedOfficialTelephone: | 4066833003 | ||||||||
IsSoleProprietor: |   | ||||||||
IsOrganizationSubpart: | N | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 01/19/2021 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282NC0060X | 9896 | MT | Y |   | Hospitals | General Acute Care Hospital | Critical Access |
No ID Information.