MEDICARE: LOGAN HEALTH - WHITEFISH

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	261QM1300X	Multi-Specialty Clinic/Center
2	261Q00000X	Clinic/Center
3	261QR1300X	Rural Health Clinic/Center	12588	MT

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	:	1336115849
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOGAN HEALTH - WHITEFISH

Provider Business Mailing Address
First Line	:	304 OSLOSKI RD
Second Line	:	PO BOX 810
City	:	EUREKA
State	:	MT
Zip	:	59917-9217
Country	:	US
Telephone Number	:	406-297-3145
Fax Number	:

Provider Business Practice Location Address
First Line	:	304 OSLOSKI RD
Second Line	:
City	:	EUREKA
State	:	MT
Zip	:	59917
Country	:	US
Telephone Number	:	406-297-3145
Fax Number	:

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	CLINTON SEGER
Credential	:	MD
Telephone Number	:	406-752-1724

Provider Enumeration Date	:	02/24/2006
Last Update Date	:	03/19/2026

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