Provider Demographics
NPI:1457716227
Name:INDIAN HEALTH SERVICE
Entity Type:Organization
Organization Name:INDIAN HEALTH SERVICE
Other - Org Name:VERNE E. GIBBS HEALTH CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:SERVICE UNIT DIRECTOR/CEO
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BEMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-768-2101
Mailing Address - Street 1:PO BOX 67
Mailing Address - Street 2:
Mailing Address - City:POPLAR
Mailing Address - State:MT
Mailing Address - Zip Code:59255-0067
Mailing Address - Country:US
Mailing Address - Phone:406-768-2101
Mailing Address - Fax:
Practice Address - Street 1:107 H STREET E
Practice Address - Street 2:
Practice Address - City:POPLAR
Practice Address - State:MT
Practice Address - Zip Code:59255
Practice Address - Country:US
Practice Address - Phone:406-768-2101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DEPT. OF HEALTH & HUMAN SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-12-22
Last Update Date:2015-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADH00006133261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental