Provider Demographics
NPI:1174165682
Name:ST. PETER'S HEALTH
Entity type:Organization
Organization Name:ST. PETER'S HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:COBURN
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:406-447-2100
Mailing Address - Street 1:2500 E BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-4901
Mailing Address - Country:US
Mailing Address - Phone:406-447-2100
Mailing Address - Fax:
Practice Address - Street 1:515 SOUTH FRONT ST
Practice Address - Street 2:
Practice Address - City:TOWNSEND
Practice Address - State:MT
Practice Address - Zip Code:59644
Practice Address - Country:US
Practice Address - Phone:406-457-4180
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST. PETER'S HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-10-16
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty