Provider Demographics
NPI:1093892705
Name:BIG HORN HOSPICE INC
Entity Type:Organization
Organization Name:BIG HORN HOSPICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HOSPICE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:UPCHURCH
Authorized Official - Suffix:
Authorized Official - Credentials:MS, MSW
Authorized Official - Phone:406-665-2699
Mailing Address - Street 1:HC 36 BOX 2010
Mailing Address - Street 2:
Mailing Address - City:HARDIN
Mailing Address - State:MT
Mailing Address - Zip Code:59034-9601
Mailing Address - Country:US
Mailing Address - Phone:406-665-2699
Mailing Address - Fax:406-665-2699
Practice Address - Street 1:HC 36 BOX 2010
Practice Address - Street 2:
Practice Address - City:HARDIN
Practice Address - State:MT
Practice Address - Zip Code:59034-9601
Practice Address - Country:US
Practice Address - Phone:406-665-2699
Practice Address - Fax:406-665-2699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT10743251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT271529Medicare Oscar/Certification