Organization
EASTERN MONTANA HEALTH COMPANY
Active
Other names
Powder River Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
LEROY N BIESHEUVEL PA/C (PHYSICIAN'S ASSISTANT)
(406) 436-2651
Entity
Organization
Contact information
Practice address
507 NORTH LINCOLN AVE, BOX 489, BROADUS, MT 59317-0489
(406) 436-2651
(406) 436-2652
Mailing address
507 NORTH LINCOLN AVE, BOX 489, BROADUS, MT 59317-0489
(406) 436-2651
(406) 436-2652
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
17
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0720070
—
MT
01
—
90943
BCBS
MT
Enumeration date
04/09/2008
Last updated
04/09/2008
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