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General NPI Number Information
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NPI Number | 1235238718
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Entity Type | Organization
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Legal Business Name | BUTTE SILVER BOW PRIMARY HEALTH CARE CLINIC INC
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 125 E GLENDALE ST
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City | DILLON
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State | MT
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Zip | 59725-2505
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Country | US
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Telephone | 406-683-4440
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Fax | 406-683-1121
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Provider Business Mailing Address
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Address Line | 445 CENTENNIAL AVE
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City | BUTTE
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State | MT
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Zip | 59701-2870
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Country | US
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Telephone | 406-723-4075
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Fax | 406-496-6035
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Authorized Official
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Title or Position | CREDENTIALING COORDINATOR
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Name | KAYLA MEDINA
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Credential |
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Telephone | 406-723-4075
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State | MT
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Taxonomy #3
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State | MT
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