Full Name | |
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Speciality | Clinic/Center |
Location | 107 H St, Poplar, Montana |
Authorized Official Name and Position | Dennis Ervin Four Bear (TRIBAL HEALTH DIRECTOR) |
Authorized Official Contact | 4067682200 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 1027 Poplar MT 59255-1027 Ph: (406) 768-2200 | 107 H St Poplar MT 59255-7817 Ph: (406) 768-2200 |
NPI Number | 1609020080 |
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Provider Enumeration Date | 11/11/2008 |
Last Update Date | 02/12/2024 |
Medicare PECOS PAC ID | 8729099445 |
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Medicare Enrollment ID | O20240812001635 |
Identifier | Type | State | Issuer |
---|---|---|---|
1609020080 | NPI | - | NPPES |