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
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1073695680 SIDNEY HEALTH CENTER
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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
1 NPI 1497743959
2 Entity Type Code 2
3 Employer Identification Number EIN
4 Provider Organization Name Legal Business Name SIDNEY HEALTH CENTER
5 Provider Other Organization Name CLINIC PHARMACY
6 Provider Other Organization Name Type Code 3
7 Provider First Line Business Practice Location Address 214 14TH AVE SW
8 Provider Business Practice Location Address City Name SIDNEY
9 Provider Business Practice Location Address State Name MT
10 Provider Business Practice Location Address Postal Code 59270
11 Provider Business Practice Location Address Country Code If outside U S US
12 Provider Business Practice Location Address Telephone Number 4064886563
13 Provider Business Practice Location Address Fax Number 4064882238
14 Provider Enumeration Date 10/10/2005
15 Last Update Date 12/22/2009
16 Authorized Official Last Name BEYERLE
17 Authorized Official First Name LYNN
18 Authorized Official Middle Name W.
19 Authorized Official Title or Position DIRECTOR OF PHARMACY
20 Authorized Official Telephone Number 4064882131
21 Healthcare Provider Taxonomy Code 1 332B00000X
22 Healthcare Provider Primary Taxonomy Switch 1 N
23 Healthcare Provider Taxonomy Code 2 183500000X
24 Provider License Number 2 1008
25 Provider License Number State Code 2 MT
26 Healthcare Provider Primary Taxonomy Switch 2 N
27 Healthcare Provider Taxonomy Code 3 3336C0003X
28 Provider License Number 3 1008
29 Provider License Number State Code 3 MT
30 Healthcare Provider Primary Taxonomy Switch 3 Y
31 Other Provider Identifier 1 211237
32 Other Provider Identifier Type Code 1 05
33 Other Provider Identifier State 1 MT
34 Other Provider Identifier 2 0296740004
35 Other Provider Identifier Type Code 2 07
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: 7/15/2014
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