Organization
MISSOULA COMMUNITY HEALTH SERVICES, INC.
Active
Parent organization
MISSOULA COMMUNITY HEALTH SERVICES, INC.
Other names
Tamarack Medical Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
MISSOULA COMMUNITY HEALTH SERVICES, INC.
Authorized official
MR. JOHN S MCNEECE (CEO)
(406) 822-4841
Entity
Organization
Contact information
Practice address
1208 6TH AVE E, SUPERIOR, MT 59872
(406) 822-4841
(406) 822-4963
Mailing address
PO BOX 66, SUPERIOR, MT 59872
(406) 822-4841
(406) 822-4963
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
MT
207Q00000X
Family Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
11203
MT
261QR1300X
Rural Health Clinic/Center
Primary
—
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000066882
BLUE CROSS BLUE SHEILD
MT
05
—
720460
—
MT
01
—
9989941
PASSPORT PROVIDER NUMBER
MT
Enumeration date
10/03/2006
Last updated
04/05/2019
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