Provider Demographics
NPI:1225502073
Name:BUTTE SILVER BOW PRIMARY HEALTH CARE CLINIC INC
Entity Type:Organization
Organization Name:BUTTE SILVER BOW PRIMARY HEALTH CARE CLINIC INC
Other - Org Name:ANACONDA CHC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHAWNA
Authorized Official - Middle Name:
Authorized Official - Last Name:YATES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-496-6018
Mailing Address - Street 1:445 CENTENNIAL AVE
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-2870
Mailing Address - Country:US
Mailing Address - Phone:406-723-4075
Mailing Address - Fax:406-496-6035
Practice Address - Street 1:110 OAK ST
Practice Address - Street 2:
Practice Address - City:ANACONDA
Practice Address - State:MT
Practice Address - Zip Code:59711-2335
Practice Address - Country:US
Practice Address - Phone:406-563-0771
Practice Address - Fax:406-563-0774
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BUTTE SILVER BOW PRIMARY HEALTH CARE CLINIC INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-01-15
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health