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312 South Adams Avenue Terry MT 59349-0156 | |
(406) 635-5511 | |
(406) 635-5510 |
Full Name | |
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Speciality | General Acute Care Hospital |
Location | 312 South Adams Avenue, Terry, Montana |
Authorized Official Name and Position | Johnna Marie Deloach (PROVIDER RELATIONS) |
Authorized Official Contact | 4066355863 |
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 156 Terry MT 59349-0156 Ph: (406) 635-5511 | 312 South Adams Avenue Terry MT 59349-0156 Ph: (406) 635-5511 |
NPI Number | 1760489272 |
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Provider Enumeration Date | 06/30/2005 |
Last Update Date | 10/18/2024 |
Medicare PECOS PAC ID | 3173501731 |
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Medicare Enrollment ID | O20040709001087 |
Identifier | Type | State | Issuer |
---|---|---|---|
1760489272 | NPI | - | NPPES |
313456 | Medicaid | MT | |
0720551 | Medicaid | MT | |
4105777 | Medicaid | MT |
Provider Name | Christine E Drivdahl-smith |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1033205687 PECOS PAC ID: 3375437692 Enrollment ID: I20040209000985 |
Provider Name | Laura R Fuhrman |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1487023990 PECOS PAC ID: 3375852254 Enrollment ID: I20151015000628 |