NPIMap

Organization Active NPI

Sidney Health Center

  • Community/Retail Pharmacy
  • Sidney, MT
National Provider Identifier
1497743959
Registry record updated Dec 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
1008 Issued in MT
Legal business name
SIDNEY HEALTH CENTER
Practice address
214 14TH Ave SW
Sidney, MT 59270
Phone
(406) 488-6563
Fax
(406) 488-2238
NPI assigned
Oct 10, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Lynn Beyerle, PHARM.D., R.PH.
Title
Pharmacist
Phone
(406) 488-2237

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 183500000X 1008 MT
Durable Medical Equipment & Medical Supplies 332B00000X
Community/Retail Pharmacy 3336C0003X 1008 MT Primary
Long Term Care Pharmacy 3336L0003X 1008 MT

Addresses

Primary practice location

214 14TH Ave SW
Sidney, MT 59270

Mailing address

214 14TH Ave SW
Sidney, MT 59270
Phone (406) 488-6563

Other identifiers 1

IdentifierTypeStateIssuer
211237MedicaidMT

Other names 1

  • Clinic Pharmacy Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sanford_toc1008865@direct.sanfordhealth.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930001066 MT DME Supplier - Pharmacy 0749181535 Practice locations: Sidney, MT
O20230204000524 MT Part B Supplier - Mass Immunization (Roster Biller Only) 0749181535 Practice locations: Sidney, MT

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Clinic Pharmacy214 14TH Ave S.W, Sidney, MT 59270(406) 488-6563 Epoetin|Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order)|Ostomy Supplies|Continuous Positive Airway Pressure (CPAP) Devices|Nebulizer Equipment and/or Supplies Does not accept assignmentParticipating since Jan 1, 2000

National Provider Directory

National Provider Directory
Tax ID family
Mondak Clinic Pharmacy9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

104 14th Ave NW
Sidney, MT 59270
Phone (406) 488-2300

1405 4th St SW
Sidney, MT 59270
Phone (406) 482-2666

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Sidney Health CenterSidney, MT, CCN 271344 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966
Sidney Health CenterSidney, MT, CCN 27Z344 Hospital 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2007
Sidney Health Center Extended CareSidney, MT, CCN 275121 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Direct Ownership Interest (100%)		 Jun 28, 1996
Feb 6, 1988
Jun 28, 1996

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 199

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 199

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607644800000",
    "number": "1497743959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 14TH AVE SW",
            "city": "SIDNEY",
            "state": "MT",
            "postal_code": "59270",
            "telephone_number": "406-488-6563",
            "fax_number": "406-488-2238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 14TH AVE SW",
            "city": "SIDNEY",
            "state": "MT",
            "postal_code": "59270",
            "telephone_number": "406-488-6563",
            "fax_number": "406-488-2238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIDNEY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-10",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A",
        "authorized_official_last_name": "BEYERLE",
        "authorized_official_first_name": "LYNN",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "406-488-2237",
        "authorized_official_credential": "PHARM.D., R.PH."
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pharmacist",
            "state": "MT",
            "license": "1008",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MT",
            "license": "1008",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "MT",
            "license": "1008",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "211237",
            "state": "MT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sanford_toc1008865@direct.sanfordhealth.org",
            "affiliation": "N",
            "endpointDescription": "Retail Pharmacy",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "sanford_toc1008865@direct.sanfordhealth.org",
            "address_1": "214 14th Ave SW",
            "city": "Sidney",
            "state": "MT",
            "country_code": "US",
            "postal_code": "592703521",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Clinic Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Clinic Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sidney, MT

Sources for this page

Verify at the official NPI Registry.