=====================================================
General NPI Number Information
=====================================================
NPI Number | 1346900529
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | US DEPT OF HEALTH & HUMAN SERVICES-DIVISION OF INDIAN HEALTH
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/29/2021
-----------------------------------------------------
Last Update Date | 03/21/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 425 SMELTER AVE NE
-----------------------------------------------------
City | GREAT FALLS
-----------------------------------------------------
State | MT
-----------------------------------------------------
Zip | 59404-1927
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 406-546-0665
-----------------------------------------------------
Fax | 406-247-7228
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 425 SMELTER AVE NE
-----------------------------------------------------
City | GREAT FALLS
-----------------------------------------------------
State | MT
-----------------------------------------------------
Zip | 59404-1927
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | HEALTH SYSTEMS SPECIALIST
-----------------------------------------------------
Name | BONNIE MCKAY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 406-247-7185
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261Q00000X
-----------------------------------------------------
Taxonomy Name | Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------