Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 3334 Dvn Lane, Darby, Montana |
Authorized Official Name and Position | John C Bishop (CEO) |
Authorized Official Contact | 4063632211 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
1224 W Main St Hamilton MT 59840-2338 Ph: (406) 375-4823 | 3334 Dvn Lane Darby MT 59829-9736 Ph: (406) 375-4142 |
NPI Number | 1396191276 |
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Provider Enumeration Date | 05/10/2016 |
Last Update Date | 09/28/2021 |
Medicare PECOS PAC ID | 5597664474 |
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Medicare Enrollment ID | O20180105000049 |
Identifier | Type | State | Issuer |
---|---|---|---|
1396191276 | NPI | - | NPPES |
1396191276 | Medicaid | MT | |
1396191276 | Medicaid | ID |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |