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General NPI Number Information
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NPI Number | 1609020080
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Entity Type | Organization
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Legal Business Name | FORT PECK TRIBES
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Dates
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Enumeration Date | 11/11/2008
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Last Update Date | 10/15/2025
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Provider Practice Location Address
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Address Line | 107 H ST
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City | POPLAR
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State | MT
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Zip | 59255-7817
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Country | US
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Telephone | 406-768-2200
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Fax | 406-768-5780
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Provider Business Mailing Address
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Address Line | PO BOX 1027
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City | POPLAR
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State | MT
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Zip | 59255-1027
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Country | US
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Telephone | 406-768-2200
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Fax | 406-768-5780
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Authorized Official
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Title or Position | TRIBAL HEALTH DIRECTOR
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Name | MR. DENNIS ERVIN FOUR BEAR
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Credential | MASTER BUSINESS
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Telephone | 406-768-2200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 344600000X
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Taxonomy Name | Taxi
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | G31-0030P
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License Number State | MT
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Taxonomy #4
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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