Organization
LIBBY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MYRESA C BOULWARE (OFFICE MANAGER)
(406) 293-8711
Entity
Organization
Contact information
Practice address
211 E 2ND ST, LIBBY, MT 59923
(406) 293-8711
(406) 293-8735
Mailing address
211 E 2ND ST, LIBBY, MT 59923-2047
(406) 293-8711
(406) 293-8735
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0730431
—
MT
01
—
CO1378
RAILROAD MEDICARE NUMBER
MT
Enumeration date
02/06/2006
Last updated
05/18/2015
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