NPIMap

Organization Active NPI

Sisters of Charity of Leavenworth Health System Inc

  • Institutional Pharmacy
  • Butte, MT
National Provider Identifier
1386719656
Registry record updated May 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Institutional PharmacyTaxonomy code 3336I0012X
Legal business name
SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM INC
Practice address
435 S Crystal St
Ste 230
Butte, MT 59701-1506
Phone
(406) 723-2441
Fax
(406) 723-2799
NPI assigned
Nov 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Carrie Dunford
Title
Chief Pharmacy Officer
Phone
(801) 284-1004

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Clinic Pharmacy 3336C0002X
Community/Retail Pharmacy 3336C0003X 1213 MT
Institutional Pharmacy 3336I0012X Primary

Addresses

Primary practice location

435 S Crystal St
Ste 230
Butte, MT 59701-1506

Mailing address

435 S Crystal St
Ste 230
Butte, MT 59701-1506
Phone (406) 723-2441

Other identifiers 3

IdentifierTypeStateIssuer
2052603OtherPK
0215101MedicaidMT
5608028MedicaidMT

Other names 2

  • Intermountain Pharmacy #11 Doing business as
  • Intermountain Health Butte Pharmacy Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180219002746 MT Part B Supplier - Pharmacy 6901879964 1 other NPI on this enrollment
Practice locations: Billings, MT; Butte, MT

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All facility ownership & control disclosures 13

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Intermountain Health St. Vincent Regional HospitalBillings, MT, CCN 270049 Hospital 5% Or Greater Direct Ownership Interest (100%) Oct 31, 2013
Intermountain Health St. Mary'S Regional HospitalGrand Junction, CO, CCN 060023 Hospital 5% Or Greater Direct Ownership Interest (100%) Dec 19, 1972
Intermountain Health St. Mary'S Regional HospitalGrand Junction, CO, CCN 06T023 Hospital 5% Or Greater Direct Ownership Interest Dec 19, 1972
Intermountain Health St. James HospitalButte, MT, CCN 270017 Hospital 5% Or Greater Direct Ownership Interest (100%) Dec 19, 1972
Intermountain Health Holy Rosary HospitalMiles City, MT, CCN 271347 Hospital 5% Or Greater Direct Ownership Interest (100%) Dec 2, 2009
Intermountain Health Holy Rosary HospitalMiles City, MT, CCN 27Z347 Hospital 5% Or Greater Direct Ownership Interest (100%) Dec 2, 2009
Intermountain Health Saint Joseph HospitalDenver, CO, CCN 060028 Hospital 5% Or Greater Direct Ownership Interest (100%) Dec 16, 2010
Intermountain Health Holy Rosary HospitalMiles City, MT, CCN 275106 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 1997
Intermountain Health Holy Rosary HospitalMiles City, MT, CCN 271519 Hospice 5% Or Greater Direct Ownership Interest (100%) Apr 1, 1997
Intermountain Health Holy Rosary HospitalMiles City, MT, CCN 273425 Rural health clinic 5% Or Greater Direct Ownership Interest Mar 21, 1997
Intermountain Health Absarokee Clinic - Family MedicineAbsarokee, MT, CCN 273831 Rural health clinic 5% Or Greater Indirect Ownership Interest (100%) Feb 16, 2022
Intermountain Health Lewistown Clinic - Family MedicineLewistown, MT, CCN 273833 Rural health clinic 5% Or Greater Indirect Ownership Interest (100%) Feb 16, 2022
Intermountain Health Boulder Clinic - Family MedicineBoulder, MT, CCN 273832 Rural health clinic 5% Or Greater Indirect Ownership Interest (100%) Feb 16, 2022

Owned or controlled facilities with NPI records 20

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 20

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714521600000",
    "number": "1386719656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 S CRYSTAL ST",
            "address_2": "STE 230",
            "city": "BUTTE",
            "state": "MT",
            "postal_code": "597011506",
            "telephone_number": "406-723-2441",
            "fax_number": "406-723-2799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 S CRYSTAL ST",
            "address_2": "STE 230",
            "city": "BUTTE",
            "state": "MT",
            "postal_code": "597011506",
            "telephone_number": "406-723-2441",
            "fax_number": "406-723-2799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-22",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A",
        "authorized_official_last_name": "DUNFORD",
        "authorized_official_first_name": "CARRIE",
        "authorized_official_title_or_position": "CHIEF PHARMACY OFFICER",
        "authorized_official_telephone_number": "801-284-1004"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MT",
            "license": "1213",
            "primary": false
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2052603",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0215101",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5608028",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Intermountain Pharmacy #11",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Intermountain Health Butte Pharmacy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Butte, MT

Sources for this page

Verify at the official NPI Registry.