GLENDIVE MEDICAL CENTER, INC (NPI# 1033129622) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033129622 |
| Entity Type | Organization |
| Organization Name | GLENDIVE MEDICAL CENTER, INC |
| Practice Address |
202 Prospect Dr Glendive MT 59330-1943 |
| Practice Telephone | 4063453306 |
| Practice Fax Number | 4063453358 |
| Mailing Telephone | 4063453306 |
| Mailing Fax Number | 4063453358 |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2017-04-06 |
| Authorized Official Name | WILLIAM ROBINSON (VP OF FINANCIAL SERVICES) |
| Authorized Official Telephone | 4063458924 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QC0050X |
Clinic/Center Specialization: Critical Access Hospital |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MT | 430768 | 05 | |
| MT | BLUE CROSS HBP | 9845 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659487445 | Glendive Medical Center, Inc | Assisted Living Facility | 1313 N Merrill Ave, Glendive, MT 59330-1900 | 2006-08-22 |
| 1174836506 | Glendive Medical Center, Inc | Hospitalist | 202 Prospect Dr, Glendive, MT 59330-1943 | 2010-07-14 |
| 1437317344 | Glendive Medical Center, Inc | Radiology | 202 Prospect Dr, Glendive, MT 59330-1943 | 2008-05-28 |
| 1275603953 | Glendive Medical Center, Inc | Pharmacy | 202 Prospect Dr, Glendive, MT 59330-1943 | 2006-11-09 |
| 1205905502 | Glendive Medical Center, Inc | Pharmacy | 202 Prospect Dr, Glendive, MT 59330-1943 | 2006-11-08 |
| 1215040449 | Glendive Medical Center, Inc | Clinic/Center | 107 Dilworth St, Glendive, MT 59330-2053 | 2006-08-15 |
| 1700896941 | Glendive Medical Center, Inc | Skilled Nursing Facility | 202 Prospect Dr, Glendive, MT 59330-1943 | 2006-08-09 |
| 1073523635 | Glendive Medical Center, Inc | Medicare Defined Swing Bed Unit | 202 Prospect Dr, Glendive, MT 59330-1943 | 2006-08-08 |
| 1366452955 | Glendive Medical Center, Inc | Hospice Care, Community Based | 202 Prospect Dr, Glendive, MT 59330-1943 | 2006-08-08 |
| 1124038716 | Glendive Medical Center, Inc | Emergency Medicine | 202 Prospect Dr, Glendive, MT 59330-1943 | 2006-08-08 |
| Street Address |
202 PROSPECT DR |
| City | GLENDIVE |
| State | MT |
| Zip Code | 59330-1943 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790701498 | Jack W. Haas | Physician Assistant | 202 Prospect Dr, Glendive, MT 59330-1943 | 2006-07-14 |
| 1346884947 | April Dawn Price | Nurse Practitioner | 202 Prospect Dr, Glendive, MT 59330-1943 | 2019-11-06 |
| 1073174538 | Eric Charles Weigel | Nurse Practitioner | 202 Prospect Dr, Glendive, MT 59330-1943 | 2019-06-25 |
| 1790293116 | Jessica Marie Domire | Nurse Practitioner | 202 Prospect Dr, Glendive, MT 59330 | 2018-01-19 |
| 1336419969 | Michael Ryan Johnson | Nurse Anesthetist, Certified Registered | 202 Prospect Dr, Glendive, MT 59330-1943 | 2012-01-12 |
| 1174836506 | Glendive Medical Center, Inc | Hospitalist | 202 Prospect Dr, Glendive, MT 59330-1943 | 2010-07-14 |
| 1255650610 | Jeffery R. Schultz | Nurse Anesthetist, Certified Registered | 202 Prospect Dr, Glendive, MT 59330-1943 | 2010-05-25 |
| 1083870042 | Shawn Patrick Regan | Nurse Anesthetist, Certified Registered | 202 Prospect Dr, Glendive, MT 59330-1943 | 2008-07-30 |
| 1437317344 | Glendive Medical Center, Inc | Radiology | 202 Prospect Dr, Glendive, MT 59330-1943 | 2008-05-28 |
| 1194884353 | John Kevin Maxwell | Radiology | 202 Prospect Dr, Glendive, MT 59330-1943 | 2006-12-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003312224 | Ashley Grammens | Pharmacist | 307 Harmon Street, Glendive, MT 59330 | 2018-04-05 |
| 1154651016 | Debra Linn | Speech-Language Pathologist | 14 Big Sky Drive, Glendive, MT 59330 | 2009-12-28 |
| 1770965972 | Nena Panasuk | Family Medicine | 107 Dilworth St, Glendive, MT 59330 | 2015-06-24 |
| 1891938882 | Monica M Melchior | Social Worker | 807 Clark Ave, Glendive, MT 59330-1400 | 2009-04-07 |
| 1275593410 | Ft Reynolds | Pharmacy | 1014 W Bell St, Glendive, MT 59330-1502 | 2006-03-23 |
| 1346296266 | Albertsons LLC | Durable Medical Equipment & Medical Supplies | 307 Harmon St, Glendive, MT 59330-1510 | 2006-05-25 |
| 1275870909 | Steve Knoop | Pharmacist | 307 Harmon St, Glendive, MT 59330-1510 | 2013-01-15 |
| 1972030708 | Calkins Dental Office, LLC | Clinic/Center | 116 N Meade Ave, Glendive, MT 59330-1604 | 2017-05-11 |
| 1598177115 | Matthew Don Calkins | Dentist | 116 N Meade Ave, Glendive, MT 59330-1604 | 2014-06-02 |
| 1770831539 | Coburn Dental Office LLC | Clinic/Center | 116 N Meade Ave, Glendive, MT 59330-1604 | 2012-08-27 |
| Find all providers in zip 59330 | ||||
| Taxonomy Code | 261QC0050X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Critical Access Hospital |
| An outpatient entity, facility, or distinct part of a facility within or affiliated with a Critical Access Hospital that provides access to primary care services for individuals in a small rural community and is Medicare certified. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174660245 | U S Health Dept of Health & Human Services | Clinic/Center | 453 Pine Grove Road, Hays, MT 59527-0620 | 2007-01-30 |
| 1801065396 | Dahl Memorial Healthcare Association Inc | Clinic/Center | 215 Sandy Street, Ekalaka, MT 59324-0046 | 2008-02-28 |
| 1932253093 | St John's Lutheran Hospital Physician's Services | Clinic/Center | 401 Louisiana Ave, Libby, MT 59923-2131 | 2007-01-23 |
| 1942367842 | U S Health Dept of Health & Human Services | Clinic/Center | 669 Agency Main St, Harlem, MT 59526-9455 | 2007-01-02 |
| 1386700763 | Fallon Medical Complex Inc | Clinic/Center | 202 South 4th Street West, Baker, MT 59313-1119 | 2006-12-29 |
| 1699845958 | Sidney Health Center | Clinic/Center | 216 14th Ave Sw, Sidney, MT 59270-3519 | 2006-11-08 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.