Full Name | |
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Speciality | Clinic/Center |
Location | 104 Rufus Ln, Polson, Montana |
Authorized Official Name and Position | Liane Clairmont (EXECUTIVE ASSISTANT) |
Authorized Official Contact | 4066764441 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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107 6th Ave Sw Ronan MT 59864-2634 Ph: (406) 676-4441 | 104 Rufus Ln Polson MT 59860-8903 Ph: (406) 883-2555 |
NPI Number | 1184785420 |
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Provider Enumeration Date | 12/12/2006 |
Last Update Date | 09/28/2018 |
Medicare PECOS PAC ID | 5496659567 |
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Medicare Enrollment ID | O20170329002669 |
Identifier | Type | State | Issuer |
---|---|---|---|
1184785420 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Wholeness In Health House-call Clinic Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 37926 Mt Highway 35, Polson, MT 59860 Phone: 406-261-5019 Fax: 406-883-6465 | |