Organization Name: | PONDERA MEDICAL CENTER |
NPI Number: | 1710901194 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARK JONES (CEO) |
Mailing Address: | 805 Sunset Blvd Conrad |
State: | MT US |
Postal Code: | 594251717 |
Phone Number: | 4062713211 |
Fax Number: | 4062717661 |
NPI Enumeration Date: | 07/27/2006 |
NPI Last Update Date: | 12/30/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QU0200X |
License Number: | 10678 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MT |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Urgent Care |
Taxonomy Definition: |