Provider Demographics
NPI:1699830661
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:MRS
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:2006-12-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0000350965Medicaid
MT0000350965Medicaid