Healthcare Provider Details

I. General information

NPI: 1093148207
Provider Name (Legal Business Name): INDIAN HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2013
Last Update Date: 08/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

760 HOSPITAL CIRCLE
BROWNING MT
59417-0730
US

IV. Provider business mailing address

760 HOPSPITAL CIRCLE
BROWNING MT
59417-0730
US

V. Phone/Fax

Practice location:
  • Phone: 406-338-6230
  • Fax:
Mailing address:
  • Phone: 406-338-6230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NR1301X
TaxonomyRural Acute Care Hospital
License Number46418
License Number StateMT

VIII. Authorized Official

Name: MISS BOBBIE JO BLACKWEASEL
Title or Position: CLINICAL NURSE
Credential: REGISTERED NURSE
Phone: 406-470-0754