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530 Central Ave W Harlem MT 59526-8078 | |
(406) 353-4861 | |
(406) 353-2721 |
Full Name | |
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Speciality | Clinic/Center |
Location | 530 Central Ave W, Harlem, Montana |
Authorized Official Name and Position | David Andrew Mark (CEO) |
Authorized Official Contact | 4066654103 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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207 W Main St Ste 5 Lewistown MT 59457-2718 Ph: (406) 357-2294 | 530 Central Ave W Harlem MT 59526-8078 Ph: (406) 353-4861 |
NPI Number | 1619160504 |
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Provider Enumeration Date | 08/23/2007 |
Last Update Date | 02/03/2023 |
Medicare PECOS PAC ID | 8820246077 |
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Medicare Enrollment ID | O20190208000562 |
Identifier | Type | State | Issuer |
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1619160504 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |