Provider Demographics
NPI:1750013991
Name:LOGAN HEALTH - SHELBY
Entity Type:Organization
Organization Name:LOGAN HEALTH - SHELBY
Other - Org Name:LOGAN HEALTH CLINIC - SHELBY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWMILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-434-3207
Mailing Address - Street 1:670 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:SHELBY
Mailing Address - State:MT
Mailing Address - Zip Code:59474-1663
Mailing Address - Country:US
Mailing Address - Phone:406-966-7040
Mailing Address - Fax:
Practice Address - Street 1:670 PARK AVE
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:MT
Practice Address - Zip Code:59474-1663
Practice Address - Country:US
Practice Address - Phone:406-966-7040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-27
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty