Healthcare Provider Details

I. General information

NPI: 1477869600
Provider Name (Legal Business Name): SCL HEALTH MEDICAL GROUP-BUTTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2010
Last Update Date: 06/06/2022
Certification Date: 06/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 S CLARK ST
BUTTE MT
59701-2328
US

IV. Provider business mailing address

400 S CLARK ST
BUTTE MT
59701-2328
US

V. Phone/Fax

Practice location:
  • Phone: 406-723-2500
  • Fax: 406-723-2483
Mailing address:
  • Phone: 406-723-2500
  • Fax: 406-723-2483

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JON MCDANIEL
Title or Position: VP FINANCE PSO OPERATIONS
Credential:
Phone: 303-272-0231