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106 E Park St Suite 1229 Ekalaka MT 59324-5932 | |
(406) 775-6332 | |
(406) 775-6242 |
Full Name | |
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Speciality | Clinic/Center |
Location | 106 E Park St, Ekalaka, Montana |
Authorized Official Name and Position | Stefanie Harrington (PUBLIC HEALTH SUPERVISOR) |
Authorized Official Contact | 4067756332 |
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 415 Ekalaka MT 59324-0415 Ph: (406) 775-6332 | 106 E Park St Suite 1229 Ekalaka MT 59324-5932 Ph: (406) 775-6332 |
NPI Number | 1265192462 |
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Provider Enumeration Date | 12/29/2021 |
Last Update Date | 02/08/2023 |
Medicare PECOS PAC ID | 4587013727 |
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Medicare Enrollment ID | O20231213000508 |
Identifier | Type | State | Issuer |
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1265192462 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP0905X | Clinic/center - Public Health, State Or Local | (* (Not Available)) | Primary |
Provider Name | Darryl M Espeland |
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Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1093745572 PECOS PAC ID: 9638071319 Enrollment ID: I20100202000330 |