Basic Information
| Provider Information | |||||||||
| NPI: | 1730129305 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BIG SANDY MEDICAL CENTER INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 530 | ||||||||
| Address2: | |||||||||
| City: | BIG SANDY | ||||||||
| State: | MT | ||||||||
| PostalCode: | 595200530 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4063782188 | ||||||||
| FaxNumber: | 4063782180 | ||||||||
| Practice Location | |||||||||
| Address1: | 166 MONTANA AVE E | ||||||||
| Address2: | |||||||||
| City: | BIG SANDY | ||||||||
| State: | MT | ||||||||
| PostalCode: | 595200530 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4063782188 | ||||||||
| FaxNumber: | 4063782180 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/08/2006 | ||||||||
| LastUpdateDate: | 10/08/2015 | ||||||||
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| AuthorizedOfficialLastName: | GRUBB | ||||||||
| AuthorizedOfficialFirstName: | LEAH | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 4063782188 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282NC0060X | 10495 | MT | Y | Hospitals | General Acute Care Hospital | Critical Access |
ID Information
| ID | Type | State | Issuer | Description | 0410774 | 05 | MT | MEDICAID | 02000057 | 01 | MT | CAH WORK COMP | OTHER | 060162 | 01 | MT | CAH BC/BS | OTHER |