| Greater Good Health Pc, Inc. | |
|
2230 N Reserve St Ste 110 Missoula MT 59808-1364 | |
| (310) 658-3775 | |
| Not Available |
| Full Name | Greater Good Health Pc, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 2230 N Reserve St Ste 110, Missoula, Montana |
| Authorized Official Name and Position | Sylvia Hastanan (VICE PRESIDENT) |
| Authorized Official Contact | 3107958807 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Greater Good Health Pc, Inc. 300 Continental Blvd Ste 635 El Segundo CA 90245-5040 Ph: (310) 658-3775 | Greater Good Health Pc, Inc. 2230 N Reserve St Ste 110 Missoula MT 59808-1364 Ph: (310) 658-3775 |
| NPI Number | 1104503168 |
|---|---|
| Provider Enumeration Date | 06/30/2023 |
| Last Update Date | 10/31/2023 |
| Medicare PECOS PAC ID | 5294106027 |
|---|---|
| Medicare Enrollment ID | O20231024001501 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104503168 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| 363LP2300X | Nurse Practitioner - Primary Care | (* (Not Available)) | Secondary |
| Provider Name | Miranda J Meunier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588838213 PECOS PAC ID: 8224196316 Enrollment ID: I20081017000535 |
| Provider Name | Lindsay A Kindelman Lande |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689003691 PECOS PAC ID: 6901034305 Enrollment ID: I20140109001845 |
| Provider Name | Elizabeth Wiener |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346639192 PECOS PAC ID: 2769709484 Enrollment ID: I20150318000030 |
| Provider Name | Lily Avgustovskiy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093122335 PECOS PAC ID: 6800118795 Enrollment ID: I20160908002041 |
| Provider Name | Marina A Rath |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710404199 PECOS PAC ID: 9537422290 Enrollment ID: I20180410001714 |
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