Provider Demographics
NPI:1699413369
Name:LITTLE SHELL HEALTH CENTER
Entity Type:Organization
Organization Name:LITTLE SHELL HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACTING CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:L
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-247-7130
Mailing Address - Street 1:425 SMELTER AVE NE
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59404-1927
Mailing Address - Country:US
Mailing Address - Phone:406-247-7130
Mailing Address - Fax:
Practice Address - Street 1:425 SMELTER AVE NE
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59404-1927
Practice Address - Country:US
Practice Address - Phone:406-247-7130
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LITTLE SHELL HEALTH CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-05-23
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332800000XSuppliersIndian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy