Provider Demographics
NPI:1831845585
Name:BIGHORN VALLEY HEALTH CENTER INCORPORATED
Entity type:Organization
Organization Name:BIGHORN VALLEY HEALTH CENTER INCORPORATED
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:GLENN
Authorized Official - Last Name:PATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-922-0843
Mailing Address - Street 1:112 W LEWIS ST
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:MT
Mailing Address - Zip Code:59047-3066
Mailing Address - Country:US
Mailing Address - Phone:406-823-6360
Mailing Address - Fax:406-222-3346
Practice Address - Street 1:112 W LEWIS ST
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:MT
Practice Address - Zip Code:59047-3066
Practice Address - Country:US
Practice Address - Phone:406-823-6360
Practice Address - Fax:406-222-3346
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BIGHORN VALLEY HEALTH CENTER, INCORPORATED
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-02-22
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy