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115 W Valentine St Glendive MT 59330-1666 | |
(406) 365-8231 | |
(406) 365-7081 |
Full Name | |
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Speciality | Clinic/Center |
Location | 115 W Valentine St, Glendive, Montana |
Authorized Official Name and Position | Gary D Jacobsen (PRESIDENT) |
Authorized Official Contact | 4063658231 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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115 W Valentine St Glendive MT 59330-1666 Ph: (406) 365-8231 | 115 W Valentine St Glendive MT 59330-1666 Ph: (406) 365-8231 |
NPI Number | 1841461563 |
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Provider Enumeration Date | 03/20/2008 |
Last Update Date | 07/15/2010 |
Medicare PECOS PAC ID | 8729119219 |
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Medicare Enrollment ID | O20100628000320 |
Identifier | Type | State | Issuer |
---|---|---|---|
1841461563 | NPI | - | NPPES |
0000026520 | Other | MT | BLUE CROSS BLUE SHIELD |
011003935 | Other | MEDICARE PTAN | |
048-0350 | Medicaid | MT | |
410008748 | Other | MT | RAILROAD MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | 453 (Montana) | Primary |
Provider Name | Troy D Myers |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1497914998 PECOS PAC ID: 8123192788 Enrollment ID: I20080731000301 |
Plains Synergy Healthcare Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 S Merrill Ave, Suite #24, Glendive, MT 59330 Phone: 406-377-1179 | |
Makoshika Wellness Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 107 W Bell St, Glendive, MT 59330 Phone: 406-359-1395 | |