Provider Demographics
NPI:1144680844
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:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:MARK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:406-665-4103
Mailing Address - Street 1:207 W MAIN ST STE 5
Mailing Address - Street 2:
Mailing Address - City:LEWISTOWN
Mailing Address - State:MT
Mailing Address - Zip Code:59457-2718
Mailing Address - Country:US
Mailing Address - Phone:406-784-2346
Mailing Address - Fax:406-784-2711
Practice Address - Street 1:112 ST LABRE CAMPUS DR
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:MT
Practice Address - Zip Code:59003-7829
Practice Address - Country:US
Practice Address - Phone:406-784-2346
Practice Address - Fax:406-784-2711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-24
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchoolGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity HealthGroup - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty