MEDICARE: FERGUS COUNTY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QF0050X	Non-Surgical Family Planning Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205901212
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FERGUS COUNTY

Provider Business Mailing Address
First Line	:	505 W MAIN ST
Second Line	:	SUITE 108
City	:	LEWISTOWN
State	:	MT
Zip	:	59457-5703
Country	:	US
Telephone Number	:	406-535-8811
Fax Number	:	406-535-8811

Provider Business Practice Location Address
First Line	:	505 W MAIN ST
Second Line	:	SUITE 108
City	:	LEWISTOWN
State	:	MT
Zip	:	59457-5703
Country	:	US
Telephone Number	:	406-535-8811
Fax Number	:	406-535-8811

Authorized Official
Title or Position	:	DIRECTOR
Name	:	SUE IRVIN
Credential	:
Telephone Number	:	406-535-8811

Provider Enumeration Date	:	11/22/2006
Last Update Date	:	03/03/2010

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Practice Location Address:

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1295891356 — NIKKI LYNNE ROGERS LCPC
Practice Location Address:

505 W MAIN ST , SUITE 325
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1659419893 — MR. DONALD E. BELL M.ED., LCPC
Practice Location Address:

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1730335282 — TRICIA LYNN WAGNER LCPC, LAC
Practice Location Address:

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Directions to “FERGUS COUNTY ” Practice Location

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