Provider Demographics
NPI:1053381483
Name:COUNTY OF GARFIELD
Entity type:Organization
Organization Name:COUNTY OF GARFIELD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSAAEN
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:406-557-2500
Mailing Address - Street 1:332 LEAVITT AVE
Mailing Address - Street 2:P.O. BOX 389
Mailing Address - City:JORDAN
Mailing Address - State:MT
Mailing Address - Zip Code:59337
Mailing Address - Country:US
Mailing Address - Phone:406-557-2500
Mailing Address - Fax:
Practice Address - Street 1:332 LEAVITT AVE
Practice Address - Street 2:
Practice Address - City:JORDAN
Practice Address - State:MT
Practice Address - Zip Code:59337
Practice Address - Country:US
Practice Address - Phone:406-557-2500
Practice Address - Fax:406-557-2700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-26
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
275N00000X, 3416L0300X
MT10016282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
No275N00000XHospital UnitsMedicare Defined Swing Bed Unit
No3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT4105530Medicaid
MT6002OtherBC PROVIDER NUMBER
MT4105530Medicaid