| Organization Name: | ROCKY BOY HEALTH CENTER |
| NPI Number: | 1891974531 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | FAWN TADIOS (CHIEF EXECUTIVE OFFICER) |
| Mailing Address: | Rr 1 Box 664 Box Elder |
| State: | MT US |
| Postal Code: | 595219797 |
| Phone Number: | 4063954486 |
| Fax Number: | 4063954138 |
| NPI Enumeration Date: | 10/30/2007 |
| NPI Last Update Date: | 10/30/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3416L0300X |
| License Number: | 102 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MT |
| Taxonomy Type: | Transportation Services |
| Taxonomy Classification: | Ambulance |
| Taxonomy Specialization: | Land Transport |
| Taxonomy Definition: | |