Provider Demographics
NPI:1124490529
Name:SCL HEALTH MEDICAL GROUP - MILES CITY, LLC
Entity type:Organization
Organization Name:SCL HEALTH MEDICAL GROUP - MILES CITY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:SLUBOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-813-5190
Mailing Address - Street 1:2420 W 26TH AVE
Mailing Address - Street 2:100D
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-5301
Mailing Address - Country:US
Mailing Address - Phone:303-813-5190
Mailing Address - Fax:
Practice Address - Street 1:2600 WILSON ST
Practice Address - Street 2:
Practice Address - City:MILES CITY
Practice Address - State:MT
Practice Address - Zip Code:59301-5094
Practice Address - Country:US
Practice Address - Phone:406-233-2500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-24
Last Update Date:2015-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty