Healthcare Provider Details

I. General information

NPI: 1376617191
Provider Name (Legal Business Name): SIDNEY HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 12/08/2020
Certification Date: 12/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 14TH AVE SW STE 107
SIDNEY MT
59270-3521
US

IV. Provider business mailing address

214 14TH AVE SW STE 107
SIDNEY MT
59270-3521
US

V. Phone/Fax

Practice location:
  • Phone: 406-488-2169
  • Fax: 406-488-2149
Mailing address:
  • Phone: 406-488-2169
  • Fax: 406-488-2149

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TINA MONTGOMERY
Title or Position: SENIOR EXECUTIVE, FINANCE/CFO
Credential:
Phone: 406-488-2117