Organization
FALLON MEDICAL COMPLEX INC
Active
Other names
Laboratory Radiology
Organization subpart
No
Provider details
NPI number
Authorized official
SELENA R NELSON (CFO)
(406) 778-5103
Entity
Organization
Contact information
Practice address
202 SOUTH 4TH STREET WEST, BAKER, MT 59313-0820
(406) 778-3331
(406) 778-5155
Mailing address
PO BOX 820, BAKER, MT 59313-0820
(406) 778-3331
(406) 778-5155
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
10663
MT
291U00000X
Clinical Medical Laboratory
10663
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000007291
BCBS LAB RADIOLOGY
MT
Enumeration date
12/29/2006
Last updated
09/11/2025
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