Provider Demographics
NPI:1215922513
Name:SIDNEY HEALTH CENTER
Entity type:Organization
Organization Name:SIDNEY HEALTH CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SENIOR EXECUTIVE, FINANCE/CFO
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTGOMERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-488-2117
Mailing Address - Street 1:104 14TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:SIDNEY
Mailing Address - State:MT
Mailing Address - Zip Code:59270-3525
Mailing Address - Country:US
Mailing Address - Phone:406-488-2300
Mailing Address - Fax:406-488-2260
Practice Address - Street 1:104 14TH AVE NW
Practice Address - Street 2:
Practice Address - City:SIDNEY
Practice Address - State:MT
Practice Address - Zip Code:59270-3525
Practice Address - Country:US
Practice Address - Phone:406-488-2300
Practice Address - Fax:406-488-2260
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SIDNEY HEALTH CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-09-13
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT10340261QA0600X
MT9669314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0351645Medicaid
MT0349323Medicaid
MT0532077Medicaid
MT0310245Medicaid
MT0532077Medicaid