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202 South 4th Street West Baker MT 59313-1119 | |
(406) 778-2833 | |
(406) 778-5155 |
Full Name | |
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Speciality | Clinic/Center |
Location | 202 South 4th Street West, Baker, Montana |
Authorized Official Name and Position | Selena R Nelson (CFO) |
Authorized Official Contact | 4067785103 |
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 1119 202 South 4th Street West Baker MT 59313-1119 Ph: (406) 778-2833 | 202 South 4th Street West Baker MT 59313-1119 Ph: (406) 778-2833 |
NPI Number | 1700895752 |
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Provider Enumeration Date | 08/07/2006 |
Last Update Date | 08/22/2020 |
Medicare PECOS PAC ID | 0941119499 |
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Medicare Enrollment ID | O20051013000381 |
Identifier | Type | State | Issuer |
---|---|---|---|
1700895752 | NPI | - | NPPES |
720369 | Medicaid | MT |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |