Healthcare Provider Details

I. General information

NPI: 1407215684
Provider Name (Legal Business Name): BLACKFEET TRIBE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2016
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 ALL CHIEFS RD
BROWNING MT
59417-5091
US

IV. Provider business mailing address

640 ALL CHIEFS RD
BROWNING MT
59417-5091
US

V. Phone/Fax

Practice location:
  • Phone: 406-338-4696
  • Fax: 406-338-2491
Mailing address:
  • Phone: 406-845-6284
  • Fax: 406-338-2491

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number State

VIII. Authorized Official

Name: THOMAS LYLE RUTHERFORD JR.
Title or Position: COUNCIL MEMBER
Credential:
Phone: 406-338-7521