Provider Demographics
NPI:1215024435
Name:HOUSE CALLS PRIMARY HEALTHCARE, PLLC
Entity Type:Organization
Organization Name:HOUSE CALLS PRIMARY HEALTHCARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:
Authorized Official - Last Name:HAWK
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:406-799-6786
Mailing Address - Street 1:3400 9TH AVE S UNIT 7164
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59406-7320
Mailing Address - Country:US
Mailing Address - Phone:406-799-6786
Mailing Address - Fax:406-206-0769
Practice Address - Street 1:3400 9TH AVE S UNIT 7164
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59406-7320
Practice Address - Country:US
Practice Address - Phone:406-799-6786
Practice Address - Fax:406-206-0769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-08
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTRN 11415363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT37003OtherBCBS
MT0432848Medicaid
MT37003OtherBCBS
MT0432848Medicaid