Provider Demographics
NPI:1083140545
Name:CROW NATION CHR HEALTH DEPT.
Entity Type:Organization
Organization Name:CROW NATION CHR HEALTH DEPT.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MAX
Authorized Official - Middle Name:M
Authorized Official - Last Name:SPOTTED BEAR
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:406-860-3988
Mailing Address - Street 1:10069 SOUTH HERITAGE RD
Mailing Address - Street 2:
Mailing Address - City:CROW AGENCY
Mailing Address - State:MT
Mailing Address - Zip Code:59022
Mailing Address - Country:US
Mailing Address - Phone:406-860-3988
Mailing Address - Fax:
Practice Address - Street 1:10069 SOUTH HERITAGE RD
Practice Address - Street 2:
Practice Address - City:CROW AGENCY
Practice Address - State:MT
Practice Address - Zip Code:59022
Practice Address - Country:US
Practice Address - Phone:406-860-3988
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-03
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)