Provider Demographics
NPI:1134242977
Name:PIONEER MEDICAL CENTER
Entity type:Organization
Organization Name:PIONEER MEDICAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:IAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PETERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-932-4603
Mailing Address - Street 1:301 W 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:BIG TIMBER
Mailing Address - State:MT
Mailing Address - Zip Code:59011-7893
Mailing Address - Country:US
Mailing Address - Phone:406-932-4199
Mailing Address - Fax:406-932-5490
Practice Address - Street 1:301 W 7TH AVE
Practice Address - Street 2:
Practice Address - City:BIG TIMBER
Practice Address - State:MT
Practice Address - Zip Code:59011-7893
Practice Address - Country:US
Practice Address - Phone:406-932-4199
Practice Address - Fax:406-932-5490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT000080224Medicare ID - Type Unspecified