Healthcare Provider Details

I. General information

NPI: 1568846962
Provider Name (Legal Business Name): BIGHORN VALLEY HEALTH CENTER INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2015
Last Update Date: 03/07/2025
Certification Date: 03/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 E 7TH ST
POWELL WY
82435-2126
US

IV. Provider business mailing address

207 W MAIN ST STE 5
LEWISTOWN MT
59457-2718
US

V. Phone/Fax

Practice location:
  • Phone: 307-764-4107
  • Fax: 307-764-1892
Mailing address:
  • Phone: 307-764-4107
  • Fax: 307-764-1879

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DAVID ANDREW MARK
Title or Position: CEO
Credential:
Phone: 406-665-4103