Healthcare Provider Details

I. General information

NPI: 1740659952
Provider Name (Legal Business Name): BOZEMAN HEALTH BIG SKY MEDICAL CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2015
Last Update Date: 10/24/2025
Certification Date: 10/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

334 TOWN CENTER AVENUE
BIG SKY MT
59716
US

IV. Provider business mailing address

915 HIGHLAND BLVD ATTENTION - PFS
BOZEMAN MT
59715-6902
US

V. Phone/Fax

Practice location:
  • Phone: 406-995-6995
  • Fax: 406-995-6999
Mailing address:
  • Phone: 406-414-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANGIE LIBERTINI
Title or Position: PAYER ENROLLMENT SUPERVISOR
Credential:
Phone: 406-414-1958