Organization
FORT PECK TRIBES
Active
Other names
Fort Peck Tribal Dialysis Unit
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS FOUR BEAR (CEO)
(406) 768-3491
Entity
Organization
Contact information
Practice address
107 H ST, POPLAR, MT 59255-1027
(406) 768-5468
(406) 768-5121
Mailing address
PO BOX 1027, POPLAR, MT 59255-1027
(406) 768-5468
(406) 768-5121
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0730041
—
MT
Enumeration date
08/31/2006
Last updated
12/27/2023
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