Healthcare Provider Details

I. General information

NPI: 1609020080
Provider Name (Legal Business Name): FORT PECK TRIBES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/11/2008
Last Update Date: 01/22/2026
Certification Date: 01/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 H ST
POPLAR MT
59255-7817
US

IV. Provider business mailing address

PO BOX 1027
POPLAR MT
59255-1027
US

V. Phone/Fax

Practice location:
  • Phone: 406-768-5790
  • Fax: 406-768-5780
Mailing address:
  • Phone: 406-768-5790
  • Fax: 406-768-5780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License NumberG31-0030P
License Number StateMT
# 4
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number State

VIII. Authorized Official

Name: MR. DENNIS ERVIN FOUR BEAR
Title or Position: TRIBAL HEALTH SERVICE UNIT DIRECTOR
Credential: MASTER BUSINESS
Phone: 406-768-5790