- Enrollment id
- O20060309000252
- Enrollment state
- MT
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1396969812
- Multiple npi flag
- N
- Ccn
- 271519
- Associate id
- 8921045667
- Organization name
- HOLY ROSARY HEALTHCARE
- Doing business as name
- INTERMOUNTAIN HEALTH HOLY ROSARY HOSPITAL
- Incorporation date
- 1961-10-10
- Incorporation state
- MT
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- N
- Address line 1
- 2600 WILSON ST
- City
- MILES CITY
- State
- MT
- Zip code
- 593015094