Healthcare Provider Details

I. General information

NPI: 1225502073
Provider Name (Legal Business Name): BUTTE SILVER BOW PRIMARY HEALTH CARE CLINIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2019
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 OAK ST
ANACONDA MT
59711-2335
US

IV. Provider business mailing address

445 CENTENNIAL AVE
BUTTE MT
59701-2870
US

V. Phone/Fax

Practice location:
  • Phone: 406-563-0771
  • Fax: 406-563-0774
Mailing address:
  • Phone: 406-723-4075
  • Fax: 406-496-6035

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: TAMMY A COX
Title or Position: EXECUTIVE DIRECTOR
Credential: PHARM D
Phone: 406-496-6018