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310 Sansome St Philipsburg MT 59858-0729 | |
(406) 859-3271 | |
(406) 859-3271 |
Full Name | |
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Speciality | Clinic/Center |
Location | 310 Sansome St, Philipsburg, Montana |
Authorized Official Name and Position | Jeffrey L Prater (C E O) |
Authorized Official Contact | 4068593271 |
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 729 310 Sansome St Philipsburg MT 59858-0729 Ph: (406) 859-3271 | 310 Sansome St Philipsburg MT 59858-0729 Ph: (406) 859-3271 |
NPI Number | 1023130754 |
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Provider Enumeration Date | 04/04/2007 |
Last Update Date | 09/21/2011 |
Medicare PECOS PAC ID | 3678480423 |
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Medicare Enrollment ID | O20100914000544 |
Identifier | Type | State | Issuer |
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1023130754 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | 10614 (Montana) | Primary |