| Details | Last Recertification Date | Update | Recertification | 2/2/2024 9:51:37 AM | 2/10/2025 1:43:08 PM | 2/10/2025 1:43 PM |
| Addresses | Shipping Address | Insert | Change Request | | Bighorn Valley Health Center, Inc dba Livingston Community Pharmacy
112 W Lewis Street
Livingston, MT 59047 | 7/22/2024 3:36 PM |
| Addresses | Shipping Address | Insert | Change Request | | Bighorn Valley Health Center, Inc dba Bozeman CHP Pharmacy
1695 Tschache Lane
Bozeman, MT 59715 | 7/22/2024 3:36 PM |
| Details | Last Recertification Date | Update | Recertification | 2/7/2023 9:52:32 AM | 2/2/2024 9:51:37 AM | 2/2/2024 9:51 AM |
| Addresses | Shipping Address | Delete | Recertification | Bighorn Valley Health Center, Inc dba Bighorn Valley Pharmacy - Ashland
501 Main St
Ashland, MT 59003-7701 | | 2/7/2023 9:52 AM |
| Details | Last Recertification Date | Update | Recertification | 2/1/2022 11:06:11 AM | 2/7/2023 9:52:32 AM | 2/7/2023 9:52 AM |
| Details | Last Recertification Date | Update | Recertification | 2/4/2021 12:11:00 PM | 2/1/2022 11:06:11 AM | 2/1/2022 11:06 AM |
| Details | Entity Subname | Update | Change Request | Bighorn Valley Health Center | One Health - Bighorn | 11/2/2021 7:26 AM |
| Addresses | Shipping Address | Insert | Change Request | | Bighorn Valley Health Center, Inc dba Bighorn Valley Pharmacy - Ashland
501 Main St
Ashland, MT 59003-7701 | 9/21/2021 2:00 PM |
| Addresses | Shipping Address | Insert | Change Request | | Bighorn Valley Health Center, Inc dba oneHealth Pharmacy
305 S 4th St
Miles City, MT 59301-4113 | 9/21/2021 2:00 PM |
| Medicaid Billing | NPI: State | Update | Recertification | | MT | 2/4/2021 12:11 PM |
| Details | Last Recertification Date | Update | Recertification | 1/30/2020 1:54:30 PM | 2/4/2021 12:11:00 PM | 2/4/2021 12:11 PM |
| Details | Last Recertification Date | Update | Recertification | 1/30/2019 11:53:18 AM | 1/30/2020 1:54:30 PM | 1/30/2020 1:54 PM |
| Addresses | Shipping Address | Insert | Change Request | | Bighorn Valley Health Center, Inc dba Bighorn Valley Pharmacy
10 West 4th Street STE B
Hardin, MT 59034-1804 | 6/27/2019 9:08 AM |
| Details | Last Recertification Date | Update | Recertification | 2/15/2018 1:40:10 PM | 1/30/2019 11:53:18 AM | 1/30/2019 11:53 AM |
| Contacts | Authorizing Official | Update | Profile Change Request | Mark, David A.
Cheif Executive Officer
BVHC.oneHealth
4066654103 | Mark, David A.
Chief Executive Officer
Bighorn Valley Health Center, Inc.
4066654103 | 2/15/2018 1:43 PM |
| Contacts | Signed By | Update | Profile Change Request | Mark, David A.
Cheif Executive Officer
BVHC.oneHealth
4066654103 | Mark, David A.
Chief Executive Officer
Bighorn Valley Health Center, Inc.
4066654103 | 2/15/2018 1:43 PM |
| Details | Last Recertification Date | Update | Recertification | 2/1/2017 12:00:00 AM | 2/15/2018 1:40:10 PM | 2/15/2018 1:40 PM |
| Contacts | Authorizing Official | Update | Recertification | Mark, David A.
Cheif Executive Officer
4066654103 | Mark, David A.
Cheif Executive Officer
BVHC.oneHealth
4066654103 | 2/9/2018 11:48 AM |
| Contacts | Signed By | Update | Recertification | Mark, David A.
Cheif Executive Officer
4066654103 | Mark, David A.
Cheif Executive Officer
BVHC.oneHealth
4066654103 | 2/9/2018 11:48 AM |
| Contacts | Primary Contact | Update | | Chosa, Stephanie
Chief Pharmacist
4066654103 | Chosa, Stephanie
Chief Pharmacist
Bighorn Valley Health Center, Inc
4066654103 | 1/10/2018 9:41 PM |
| Addresses | Main Address | Insert | | |
10 West 4th Street STE B
Hardin, MT 59034-1804 | 2/1/2017 5:27 PM |
| Contacts | Primary Contact | Insert | | | Chosa, Stephanie
Chief Pharmacist
4066654103 | 2/1/2017 5:27 PM |
| Contacts | Authorizing Official | Insert | | | Mark, David A.
Cheif Executive Officer
4066654103 | 2/1/2017 5:27 PM |
| Contacts | Signed By | Insert | | | Mark, David A.
Cheif Executive Officer
4066654103 | 2/1/2017 5:27 PM |
| Details | Last Recertification Date | Update | | 2/25/2016 12:00:00 AM | 2/1/2017 12:00:00 AM | 2/1/2017 5:27 PM |
| Medicaid Billing | NPI: Number | Insert | | | 1255617130 | 2/25/2016 1:27 PM |
| Details | Last Recertification Date | Update | | 2/10/2015 12:00:00 AM | 2/25/2016 12:00:00 AM | 2/25/2016 1:27 PM |
| Details | Last Recertification Date | Update | | 3/14/2014 12:00:00 AM | 2/10/2015 12:00:00 AM | 2/10/2015 3:11 PM |
| Details | Last Recertification Date | Update | | 4/1/2013 12:00:00 AM | 3/14/2014 12:00:00 AM | 3/14/2014 4:12 PM |
| Details | Entity Name | Update | | Bighorn Valley Health Center | BIGHORN VALLEY HEALTH CENTER, INC | 3/14/2014 4:12 PM |
| Details | Entity Subname | Update | | | Bighorn Valley Health Center | 3/14/2014 4:12 PM |
| Details | Last Recertification Date | Update | | | 4/1/2013 12:00:00 AM | 2/6/2013 7:33 AM |
| Details | 340B ID | Update | | IS-FF-CHC24102-00 | CHC24102-00 | 11/16/2012 5:52 PM |
| Dates | Participating Approval Date | Update | | | 11/16/2012 12:00:00 AM | 11/16/2012 5:52 PM |
| Details | State | Update | | Pending | Active | 11/16/2012 5:52 PM |
| Dates | Start Date | Update | | | 1/1/2013 12:00:00 AM | 11/16/2012 5:52 PM |
| Details | 340B ID | Update | | ONLINE_REG | IS-FF-CHC24102-00 | 11/13/2012 12:46 PM |
| Details | Last Recertification Date | Insert | | | | 9/16/2012 12:45 AM |
| Details | Grant Number | Insert | | | H80CS24102 | 9/16/2012 12:45 AM |
| Details | 340B ID | Insert | | | ONLINE_REG | 9/16/2012 12:45 AM |
| Details | Is Authorizing Official EHB Data | Insert | | | | 9/16/2012 12:45 AM |
| Dates | Last Date That 340B Drugs Purchased | Insert | | | | 9/16/2012 12:45 AM |
| Details | Medicare Provider Number | Insert | | | | 9/16/2012 12:45 AM |
| Details | Entity Name | Insert | | | Bighorn Valley Health Center | 9/16/2012 12:45 AM |
| Details | Program Code | Insert | | | CH | 9/16/2012 12:45 AM |
| Details | Entity Subname | Insert | | | | 9/16/2012 12:45 AM |
| Dates | Participating Approval Date | Insert | | | | 9/16/2012 12:45 AM |
| Details | State | Insert | | | Pending | 9/16/2012 12:45 AM |
| Dates | Registration Date | Insert | | | 9/16/2012 12:00:00 AM | 9/16/2012 12:45 AM |
| Dates | Signed By Date | Insert | | | 9/16/2012 12:00:00 AM | 9/16/2012 12:45 AM |
| Dates | Start Date | Insert | | | | 9/16/2012 12:45 AM |
| Terminations | Termination Comments | Insert | | | | 9/16/2012 12:45 AM |
| Terminations | Termination Date | Insert | | | | 9/16/2012 12:45 AM |
| Terminations | Termination Effective Date | Insert | | | | 9/16/2012 12:45 AM |
| Terminations | Termination Reason | Insert | | | | 9/16/2012 12:45 AM |