Provider Demographics
NPI:1891974531
Name:ROCKY BOY HEALTH CENTER
Entity Type:Organization
Organization Name:ROCKY BOY HEALTH CENTER
Other - Org Name:ROCKY BOY AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:APPLICATIONS COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:HESTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-395-4486
Mailing Address - Street 1:RR 1 BOX 664
Mailing Address - Street 2:
Mailing Address - City:BOX ELDER
Mailing Address - State:MT
Mailing Address - Zip Code:59521-9797
Mailing Address - Country:US
Mailing Address - Phone:406-395-4486
Mailing Address - Fax:406-395-4138
Practice Address - Street 1:6850 UPPER BOX ELDER RD
Practice Address - Street 2:
Practice Address - City:BOX ELDER
Practice Address - State:MT
Practice Address - Zip Code:59521-9073
Practice Address - Country:US
Practice Address - Phone:406-395-1617
Practice Address - Fax:406-395-4138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-30
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1023416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport