NPIMap

Organization Active NPI

Glendive Medical Center, Inc

Doing business as The Heritage on Merrill Avenue

  • Assisted Living Facility
  • Glendive, MT
National Provider Identifier
1659487445
Registry record updated Mar 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
GLENDIVE MEDICAL CENTER, INC
Doing business as
The Heritage on Merrill Avenue
Practice address
1313 N Merrill Ave
Glendive, MT 59330-1900
Phone
(406) 377-7700
Fax
(406) 377-7701
NPI assigned
Aug 22, 2006
Last updated
Mar 4, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2021

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

Authorized official

Name
William Robinson
Title
VP of Financial Services
Phone
(406) 345-8924

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

1313 N Merrill Ave
Glendive, MT 59330-1900

Mailing address

202 Prospect Dr
Glendive, MT 59330-1943
Phone (406) 345-3306

Other names 1

  • The Heritage on Merrill Avenue Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
27D2204016Glendive Medical Center Heritage1313 N Merrill Ave #101, Glendive, MT 59330Certificate of waiverDec 6, 2026

National Provider Directory

National Provider Directory
Tax ID family
Glendive Medical Center Inc12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614816000000",
    "number": "1659487445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 PROSPECT DR",
            "city": "GLENDIVE",
            "state": "MT",
            "postal_code": "593301943",
            "telephone_number": "406-345-3306",
            "fax_number": "406-345-3358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 N MERRILL AVE",
            "city": "GLENDIVE",
            "state": "MT",
            "postal_code": "593301900",
            "telephone_number": "406-377-7700",
            "fax_number": "406-377-7701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENDIVE MEDICAL CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-22",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "VP OF FINANCIAL SERVICES",
        "authorized_official_telephone_number": "406-345-8924"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Heritage on Merrill Avenue",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Heritage on Merrill Avenue",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glendive, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.