Provider Demographics
NPI:1700104817
Name:COUNTY OF FERGUS
Entity Type:Organization
Organization Name:COUNTY OF FERGUS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL ADVISOR
Authorized Official - Prefix:
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:HOLMES
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:406-535-7433
Mailing Address - Street 1:712 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LEWISTOWN
Mailing Address - State:MT
Mailing Address - Zip Code:59457-2562
Mailing Address - Country:US
Mailing Address - Phone:406-535-7433
Mailing Address - Fax:406-535-7434
Practice Address - Street 1:712 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LEWISTOWN
Practice Address - State:MT
Practice Address - Zip Code:59457-2562
Practice Address - Country:US
Practice Address - Phone:406-535-7433
Practice Address - Fax:406-535-7434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-13
Last Update Date:2010-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT000003369OtherMEDICARE ID - TYPE UNSPECIFIED