| Mon Dak Family Clinic | |
|
304 S Ellery Fairview MT 59221 | |
| (406) 742-5261 | |
| (406) 742-5263 |
| Full Name | Mon Dak Family Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 304 S Ellery, Fairview, Montana |
| Authorized Official Name and Position | Tina Montgomery (SENIOR EXECUTIVE, FINIANCE/CFO) |
| Authorized Official Contact | 4064882117 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mon Dak Family Clinic 214 14th Ave Sw Suite 107 Sidney MT 59270 Ph: (406) 488-2169 | Mon Dak Family Clinic 304 S Ellery Fairview MT 59221 Ph: (406) 742-5261 |
| NPI Number | 1730252883 |
|---|---|
| Provider Enumeration Date | 11/16/2006 |
| Last Update Date | 12/08/2020 |
| Medicare PECOS PAC ID | 0749181535 |
|---|---|
| Medicare Enrollment ID | O20060417000509 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730252883 | NPI | - | NPPES |
| 0720161 | Medicaid | MT | |
| 63062 | Other | MT | BLUE CROSS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Ag Worker Health & Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 35511 County Road 134, Fairview, MT 59221 Phone: 406-742-5201 Fax: 406-742-3563 |