Healthcare Provider Details

I. General information

NPI: 1568532802
Provider Name (Legal Business Name): SIDNEY HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

216 14TH AVE SW
SIDNEY MT
59270-3519
US

IV. Provider business mailing address

216 14TH AVE SW
SIDNEY MT
59270-3519
US

V. Phone/Fax

Practice location:
  • Phone: 406-488-2100
  • Fax: 406-488-2125
Mailing address:
  • Phone: 406-488-2100
  • Fax: 406-488-2125

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License Number10905
License Number StateMT

VIII. Authorized Official

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