Provider Demographics
NPI:1497041941
Name:CROW TRIBE OF INDIANS
Entity Type:Organization
Organization Name:CROW TRIBE OF INDIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CROW TRIBAL ATTORNEY
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:M
Authorized Official - Last Name:BEAR DON'T WALK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-679-2723
Mailing Address - Street 1:10069 SOUTH HERITAGE ROAD
Mailing Address - Street 2:BOX 159
Mailing Address - City:CROW AGENCY
Mailing Address - State:MT
Mailing Address - Zip Code:59022
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10110 SOUTH 7650 EAST
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:406-638-2626
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-23
Last Update Date:2018-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)Group - Multi-Specialty