Provider Demographics
NPI:1255582615
Name:MARIAS HEALTHCARE SERVICES INC
Entity type:Organization
Organization Name:MARIAS HEALTHCARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:F
Authorized Official - Last Name:BROWNELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-434-3110
Mailing Address - Street 1:422 MONTANA
Mailing Address - Street 2:
Mailing Address - City:VALIER
Mailing Address - State:MT
Mailing Address - Zip Code:59486-0554
Mailing Address - Country:US
Mailing Address - Phone:406-434-3100
Mailing Address - Fax:406-434-3143
Practice Address - Street 1:422 MONTANA
Practice Address - Street 2:
Practice Address - City:VALIER
Practice Address - State:MT
Practice Address - Zip Code:59486
Practice Address - Country:US
Practice Address - Phone:406-434-3116
Practice Address - Fax:406-434-3143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-03
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT261QD0000X
MT271827261QF0400X
271826261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT271827Medicare Oscar/Certification
000008425Medicare PIN
0815980001Medicare NSC