Healthcare Provider Details

I. General information

NPI: 1124171426
Provider Name (Legal Business Name): BOZEMAN HEALTH BIG SKY MEDICAL CENTER PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 03/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

334 TOWN CENTER AVE
BIG SKY MT
59716-1529
US

IV. Provider business mailing address

PO BOX 161529 334 TOWN CENTER AVE
BIG SKY MT
59716-1529
US

V. Phone/Fax

Practice location:
  • Phone: 406-995-6500
  • Fax: 406-995-6510
Mailing address:
  • Phone: 406-995-6500
  • Fax: 406-995-6510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH LEWIS
Title or Position: COO
Credential:
Phone: 406-414-5000