Provider Demographics
NPI:1275690208
Name:PIONEER MEDICAL CENTER
Entity Type:Organization
Organization Name:PIONEER MEDICAL CENTER
Other - Org Name:PIONEER MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:IAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PETERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-932-4603
Mailing Address - Street 1:PO BOX 1228
Mailing Address - Street 2:
Mailing Address - City:BIG TIMBER
Mailing Address - State:MT
Mailing Address - Zip Code:59011-1228
Mailing Address - Country:US
Mailing Address - Phone:406-932-4603
Mailing Address - Fax:406-932-5468
Practice Address - Street 1:301 W 7TH AVE
Practice Address - Street 2:SUITE RHC
Practice Address - City:BIG TIMBER
Practice Address - State:MT
Practice Address - Zip Code:59011-7893
Practice Address - Country:US
Practice Address - Phone:406-932-4199
Practice Address - Fax:406-932-5468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT66932OtherBCBS
MT0720494Medicaid
MT0720494Medicaid