Provider Demographics
NPI:1205901212
Name:FERGUS COUNTY
Entity type:Organization
Organization Name:FERGUS COUNTY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SUE
Authorized Official - Middle Name:
Authorized Official - Last Name:IRVIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-535-8811
Mailing Address - Street 1:505 W MAIN ST
Mailing Address - Street 2:SUITE 108
Mailing Address - City:LEWISTOWN
Mailing Address - State:MT
Mailing Address - Zip Code:59457-5703
Mailing Address - Country:US
Mailing Address - Phone:406-535-8811
Mailing Address - Fax:406-535-8811
Practice Address - Street 1:505 W MAIN ST
Practice Address - Street 2:SUITE 108
Practice Address - City:LEWISTOWN
Practice Address - State:MT
Practice Address - Zip Code:59457-5703
Practice Address - Country:US
Practice Address - Phone:406-535-8811
Practice Address - Fax:406-535-8811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT4306780Medicaid
MT1811984420Medicare PIN
MT1467662684Medicare PIN
MT000084269Medicare PIN
MT1851352736Medicare PIN