Healthcare Provider Details

I. General information

NPI: 1932575149
Provider Name (Legal Business Name): BIGHORN VALLEY HEALTH CENTER, INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2015
Last Update Date: 06/24/2022
Certification Date: 06/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 MAIN STREET
ASHLAND MT
59003
US

IV. Provider business mailing address

10 4TH ST W
HARDIN MT
59034-1802
US

V. Phone/Fax

Practice location:
  • Phone: 406-784-2346
  • Fax: 406-784-2711
Mailing address:
  • Phone: 406-665-4103
  • Fax: 406-867-4103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID MARK
Title or Position: CEO
Credential: MD
Phone: 406-665-4103