Healthcare Provider Details

I. General information

NPI: 1609954759
Provider Name (Legal Business Name): BIG SANDY MEDICAL CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

166 MONTANA AVE EAST
BIG SANDY MT
59520-0530
US

IV. Provider business mailing address

PO BOX 530
BIG SANDY MT
59520-0530
US

V. Phone/Fax

Practice location:
  • Phone: 406-378-2189
  • Fax: 406-378-2180
Mailing address:
  • Phone: 406-378-2189
  • Fax: 406-378-2180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number StateMT

VIII. Authorized Official

Name: HARRY BOLD
Title or Position: ADMINISTRATOR
Credential:
Phone: 406-378-2189