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General NPI Number Information
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NPI Number | 1073781548
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Entity Type | Organization
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Legal Business Name | GREAT FALLS CLINIC
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Dates
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Enumeration Date | 02/18/2008
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Last Update Date | 06/03/2010
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Provider Practice Location Address
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Address Line | 124 MAIN AVENUE NORTH
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City | CHOTEAU
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State | MT
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Zip | 59422-9410
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Country | US
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Telephone | 406-466-5255
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Fax | 406-466-5256
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Provider Business Mailing Address
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Address Line | 1400 29TH ST S
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City | GREAT FALLS
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State | MT
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Zip | 59405-5353
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Country | US
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Telephone | 406-454-2141
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Fax | 406-771-3021
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Authorized Official
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Title or Position | CHIEF ADMINISTRATIVE OFFICER
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Name | MARTIN H SINCLAIR
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Credential |
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Telephone | 406-454-2171
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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