NPIMap

Organization Active NPI

Lodge Grass Health Center Pharmacy

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Lodge Grass, MT
National Provider Identifier
1669501649
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Indian Health Service/Tribal/Urban Indian Health (I/T/U) PharmacyTaxonomy code 332800000X
Legal business name
LODGE GRASS HEALTH CENTER PHARMACY
Practice address
Harding Ave
Lodge Grass, MT 59050
Phone
(406) 639-2317
Fax
(406) 639-2976
NPI assigned
Mar 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Cynthia Larsen
Title
Area Business Office Coordinator
Phone
(406) 247-7184

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 332800000X Primary

Addresses

Primary practice location

Harding Ave
Lodge Grass, MT 59050

Mailing address

Harding Ave
PO Box 780
Lodge Grass, MT 59050
Phone (406) 639-2317

Other identifiers 2

IdentifierTypeStateIssuer
2762955OtherNCPDP NUMBER
2210085MedicaidMT

National Provider Directory

National Provider Directory
Tax ID family
Heart Butte Health Station Pharmacy26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

Organizations that report the same tax identification number in the National Provider Directory.

View all 25

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1669501649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HARDING AVE",
            "address_2": "PO BOX 780",
            "city": "LODGE GRASS",
            "state": "MT",
            "postal_code": "59050",
            "telephone_number": "406-639-2317",
            "fax_number": "406-639-2976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HARDING AVE",
            "city": "LODGE GRASS",
            "state": "MT",
            "postal_code": "59050",
            "telephone_number": "406-639-2317",
            "fax_number": "406-639-2976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LODGE GRASS HEALTH CENTER PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "LARSEN",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "AREA BUSINESS OFFICE COORDINATOR",
        "authorized_official_telephone_number": "406-247-7184"
    },
    "taxonomies": [
        {
            "code": "332800000X",
            "taxonomy_group": "",
            "desc": "Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP NUMBER",
            "identifier": "2762955",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2210085",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lodge Grass, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.