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NPI Code Detail

MEDICARE: BIGHORN VALLEY HEALTH CENTER, INCORPORATED

MEDICARE: BIGHORN VALLEY HEALTH CENTER, INCORPORATED
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
1261QF0400XFederally Qualified Health Center (FQHC)

General Provider Information

NPI Number : 1780363960
Entity Type Code : Organization
Provider Name (Legal Business Name) : BIGHORN VALLEY HEALTH CENTER, INCORPORATED
Provider Business Mailing Address
First Line : 207 W MAIN ST STE 5
Second Line :
City : LEWISTOWN
State : MT
Zip : 59457-2718
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 31 E WHITNEY ST
Second Line :
City : SHERIDAN
State : WY
Zip : 82801-4889
Country : US
Telephone Number : 307-674-6995
Fax Number :
Authorized Official
Title or Position : CEO
Name : DAVID ANDREW MARK
Credential : MD
Telephone Number : 406-665-4103
Provider Enumeration Date : 07/14/2023
Last Update Date : 04/15/2024

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Directions to “BIGHORN VALLEY HEALTH CENTER, INCORPORATED ” Practice Location

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