| Missoula Community Health Services, Inc | |
|
1208 6th Ave Superior MT 59872-9618 | |
| (406) 822-4278 | |
| (406) 822-4912 |
| Full Name | Missoula Community Health Services, Inc |
|---|---|
| Speciality | General Practice |
| Location | 1208 6th Ave, Superior, Montana |
| Authorized Official Name and Position | John S Mcneece (CEO) |
| Authorized Official Contact | 4068224841 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Missoula Community Health Services, Inc Po Box 66 Superior MT 59872-0066 Ph: (406) 822-4278 | Missoula Community Health Services, Inc 1208 6th Ave Superior MT 59872-9618 Ph: (406) 822-4278 |
| NPI Number | 1710165105 |
|---|---|
| Provider Enumeration Date | 02/07/2008 |
| Last Update Date | 04/05/2019 |
| Medicare PECOS PAC ID | 6709790603 |
|---|---|
| Medicare Enrollment ID | O20031114000597 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710165105 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Timothy J Johnston |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1043262934 PECOS PAC ID: 8224045133 Enrollment ID: I20060721000095 |
| Provider Name | Rachel N Depuy |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1821249624 PECOS PAC ID: 0840344610 Enrollment ID: I20090812000807 |
| Provider Name | Tana Marie Taylor |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1750601423 PECOS PAC ID: 2961527825 Enrollment ID: I20120508000462 |
| Provider Name | Roger Pafford |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497802797 PECOS PAC ID: 1355415977 Enrollment ID: I20130411000521 |
| Provider Name | Bruce Mcclelland |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1851397038 PECOS PAC ID: 9335270339 Enrollment ID: I20150402000349 |
| Provider Name | Betty Jo Nelson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1467555847 PECOS PAC ID: 6406743954 Enrollment ID: I20160204001361 |
| Provider Name | Jane A Whetzel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558470393 PECOS PAC ID: 9335129493 Enrollment ID: I20161024000984 |
| Provider Name | Christopher J Maki |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1871806117 PECOS PAC ID: 8820307986 Enrollment ID: I20170113002478 |
| Provider Name | Carlos E Morales |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1306863808 PECOS PAC ID: 6901848654 Enrollment ID: I20180102001193 |
| Provider Name | Brian Matthew Lopez |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1578940888 PECOS PAC ID: 8123379971 Enrollment ID: I20180918003623 |
| Provider Name | Jacob A Whetzel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548655368 PECOS PAC ID: 8224317367 Enrollment ID: I20190319002639 |
| Provider Name | Matthew Madden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417424854 PECOS PAC ID: 5890023808 Enrollment ID: I20190828001585 |
| Provider Name | Karyn Ridgeway |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1134362619 PECOS PAC ID: 2062669534 Enrollment ID: I20200225000469 |
| Provider Name | Morgan S Kellogg |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1730522079 PECOS PAC ID: 8022303783 Enrollment ID: I20200709001278 |
| Provider Name | Christopher John Hallberg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194257865 PECOS PAC ID: 5890049399 Enrollment ID: I20200924001094 |
Missoula Community Health Services, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1208 6th Ave, Superior, MT 59872 Phone: 406-822-4841 | |
Mineral Regional Health Center Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1208 6th Ave, Superior, MT 59872 Phone: 406-822-4278 | |
Missoula Community Health Services, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1208 6th Ave E, Superior, MT 59872 Phone: 406-822-4841 Fax: 406-822-4963 | |
Terry A. Smith M.c.p.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 310 Spruce St, Superior, MT 59872 Phone: 406-822-4100 |