Provider Demographics
NPI:1144883984
Name:BUTTE SILVER BOW PRIMARY HEALTH CARE CLINIC INC
Entity type:Organization
Organization Name:BUTTE SILVER BOW PRIMARY HEALTH CARE CLINIC INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:406-496-6033
Mailing Address - Street 1:445 CENTENNIAL AVE
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-2870
Mailing Address - Country:US
Mailing Address - Phone:406-496-6000
Mailing Address - Fax:406-496-6035
Practice Address - Street 1:125 E GLENDALE ST
Practice Address - Street 2:
Practice Address - City:DILLON
Practice Address - State:MT
Practice Address - Zip Code:59725-2505
Practice Address - Country:US
Practice Address - Phone:406-988-0772
Practice Address - Fax:406-988-0774
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BUTTE SILVER BOW PRIMARY HEALTH CARE CLINIC INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-04-17
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy