| Prov St Joseph Med Ctr Polson | |
|
6 13th Ave E Polson MT 59860-5315 | |
| (406) 883-5680 | |
| (406) 883-8926 |
| Full Name | Prov St Joseph Med Ctr Polson |
|---|---|
| Speciality | Clinic/Center |
| Location | 6 13th Ave E, Polson, Montana |
| Authorized Official Name and Position | Donald Wayne Anderson (ASST SEC FOR ENROLLMENT/DIR REIMB S) |
| Authorized Official Contact | 4255255392 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prov St Joseph Med Ctr Polson Po Box 262 Liberty Lake WA 99019-0262 Ph: () - | Prov St Joseph Med Ctr Polson 6 13th Ave E Polson MT 59860-5315 Ph: (406) 883-5680 |
| NPI Number | 1609104165 |
|---|---|
| Provider Enumeration Date | 11/20/2009 |
| Last Update Date | 10/29/2021 |
| Medicare PECOS PAC ID | 0446230247 |
|---|---|
| Medicare Enrollment ID | O20100219000280 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609104165 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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