Provider Demographics
NPI:1902390404
Name:BIG SKY MANAGED CARE
Entity Type:Organization
Organization Name:BIG SKY MANAGED CARE
Other - Org Name:BIG SKY MANAGED CARE MONTANA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-788-5183
Mailing Address - Street 1:PO BOX 1049
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59403-1049
Mailing Address - Country:US
Mailing Address - Phone:406-788-5183
Mailing Address - Fax:
Practice Address - Street 1:900 13TH AVE S
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-4426
Practice Address - Country:US
Practice Address - Phone:406-788-5183
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-18
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy