SIDNEY HEALTH CENTER (CLINIC PHARMACY) - NPI NUMBER 1497743959

Summary

Provider Name: SIDNEY HEALTH CENTER (CLINIC PHARMACY)

NPI Number: 1497743959

Clasification: Durable Medical Equipment & Medical Supplies (332B00000X)

Address:
214 14TH AVE SW
SIDNEY, MT
ZIP 59270

Phone Number: (406) 488-6563



Detailed Information

SIDNEY HEALTH CENTER is a durable medical equipment & medical supplies in Sidney, MT. The provider is a supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient�s use in the home and that are usable for an extended period of time. The assigned NPI number for this provider is 1497743959 and is registered as an organization entity type.
The provider Is Doing Business As Clinic Pharmacy.

The provider's business address is:

214 14TH AVE SW
SIDNEY, MT
ZIP 59270
Phone: (406) 488-6563
Fax: (406) 488-2238

The provider's authorized official is Lynn W. Beyerle .
The authorized official title is Director Of Pharmacy and has the following contact phone number (406) 488-2131.

The enumeration date for this NPI number is 10/10/2005 and was last updated on 12/22/2009.

Map - Location of Practice

Similar Providers

NPI Provider Name / Taxonomy
1770672388 WHITE DRUG ENTERPRISES INC
Durable Medical Equipment & Medical Supplies
1073695680 SIDNEY HEALTH CENTER
Durable Medical Equipment & Medical Supplies
1659597532 LINCARE INC
Durable Medical Equipment & Medical Supplies





Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 332B00000X Durable Medical Equipment & Medical Supplies No
2 183500000X Pharmacist 1008 MT No
3 3336C0003X Pharmacy Community/Retail Pharmacy 1008 MT Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 211237 MEDICAID MT
2 0296740004 MEDICARE NSC

NPI Record

No. Field Name Field Value Field Definition 1
1 NPI 1497743959 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 2 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Employer Identification Number EIN The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
4 Provider Organization Name Legal Business Name SIDNEY HEALTH CENTER The name of the organization provider. If the provider is an organization, this is the legal business name.
5 Provider Other Organization Name CLINIC PHARMACY Other name by which the organization provider is or has been known.
6 Provider Other Organization Name Type Code 3 Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
7 Provider First Line Business Practice Location Address 214 14TH AVE SW The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
8 Provider Business Practice Location Address City Name SIDNEY The city name in the location address of the provider being identified.
9 Provider Business Practice Location Address State Name MT The State code in the location of the provider being identified.
10 Provider Business Practice Location Address Postal Code 59270 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
11 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
12 Provider Business Practice Location Address Telephone Number 4064886563 The telephone number associated with the location address of the provider being identified.
13 Provider Business Practice Location Address Fax Number 4064882238 The fax number associated with the location address of the provider being identified.
14 Provider Enumeration Date 10/10/2005 The date the provider was assigned a unique identifier (assigned an NPI).
15 Last Update Date 12/22/2009 The date that a record was last updated or changed.
16 Authorized Official Last Name BEYERLE The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
17 Authorized Official First Name LYNN The first name of the authorized official.
18 Authorized Official Middle Name W. The middle name of the authorized official.
19 Authorized Official Title or Position DIRECTOR OF PHARMACY The title or position of the authorized official.
20 Authorized Official Telephone Number 4064882131 The 10-position telephone number of the authorized official.
21 Healthcare Provider Taxonomy Code 1 332B00000X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
22 Healthcare Provider Primary Taxonomy Switch 1 N
23 Healthcare Provider Taxonomy Code 2 183500000X
24 Provider License Number 2 1008 The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
25 Provider License Number State Code 2 MT The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
26 Healthcare Provider Primary Taxonomy Switch 2 N
27 Healthcare Provider Taxonomy Code 3 3336C0003X
28 Provider License Number 3 1008 The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
29 Provider License Number State Code 3 MT The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
30 Healthcare Provider Primary Taxonomy Switch 3 Y
31 Other Provider Identifier 1 211237 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
32 Other Provider Identifier Type Code 1 05 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
33 Other Provider Identifier State 1 MT
34 Other Provider Identifier 2 0296740004 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
35 Other Provider Identifier Type Code 2 07 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
36 Is Organization Subpart N
37 Authorized Official Name Prefix Text DR.
38 Authorized Official Credential Text PHARM.D., R.PH.
39 Healthcare Provider Taxonomy Group 2 193400000X MULTIPLE SINGLE SPECIALTY GROUP

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This page was last updated on: 3/10/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

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