MEDICARE: BIG SKY HOME CARE SERVICES L.L.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	C152351	MT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205048121
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BIG SKY HOME CARE SERVICES L.L.C.

Provider Business Mailing Address
First Line	:	1 JACKSON CREEK ROAD
Second Line	:	PMB 2197
City	:	MONTANA CITY
State	:	MT
Zip	:	59634
Country	:	US
Telephone Number	:	406-442-2984
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 JACKSON CREEK ROAD
Second Line	:	PMB 2197
City	:	MONTANA CITY
State	:	MT
Zip	:	59634
Country	:	US
Telephone Number	:	406-442-2984
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. CONDA POLAND
Credential	:
Telephone Number	:	406-442-2984

Provider Enumeration Date	:	05/04/2007
Last Update Date	:	08/22/2020

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