Organization
FALLON MEDICAL COMPLEX INC
Active
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, 202 SOUTH 4TH STREET WEST, BAKER, MT 59313-0820
(406) 778-3331
(406) 778-5155
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
10663
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000060632
CAH BLUE CROSS
MT
05
—
0412360
—
MT
Enumeration date
07/17/2006
Last updated
10/09/2012
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