Addresses | Main Address | Update | Change Request |
1101 N Emmett Ave
Butte, MT 59701 |
1101 N Emmett Ave
Butte, MT 59701-8514 | 5/7/2025 1:58 PM |
Contacts | Authorizing Official | Update | Change Request | Davis, Michele K
CFO
Butte Silver Bow Primary Health Care, Inc
4064966025 | Cox, Tammy
Executive Director
Butte Silver Bow Primary Health Care
4064966018 | 5/7/2025 1:58 PM |
Contacts | Primary Contact | Update | Change Request | Cox, Tammy
Executive Director
Butte Silver Bow Primary Health Care
4064966018 | McGree, Kate
Director of Pharmacy
Butte Silver Bow Primary Health Care
4064966033 | 5/7/2025 1:58 PM |
Details | Entity Name | Update | Change Request | Butte-Silver Bow Primary Health Care Clinic, Inc. | BUTTE-SILVER BOW PRIMARY HEALTH CARE CLINIC, INC | 5/7/2025 1:58 PM |
Addresses | Main Address | Update | Recertification |
1101 N Emmett Ave
Butte, MT 59701-8514 |
1101 N Emmett Ave
Butte, MT 59701 | 3/3/2025 8:11 AM |
Addresses | Billing Address | Update | Recertification | Butte-silver Bow Primary Health Care Clinic, Inc.
445 Centennial Ave.
Butte, MT 59701 | Butte-Silver Bow Primary Health Care Clinic, Inc.
445 Centennial Ave
Butte, MT 59701 | 3/3/2025 8:11 AM |
Details | Last Recertification Date | Update | Recertification | 2/8/2024 7:40:48 PM | 3/3/2025 8:11:35 AM | 3/3/2025 8:11 AM |
Details | Entity Name | Update | Recertification | Butte-silver Bow Primary Health Care Clinic, Inc. | Butte-Silver Bow Primary Health Care Clinic, Inc. | 3/3/2025 8:11 AM |
Details | Last Recertification Date | Update | Recertification | 2/22/2023 2:23:30 PM | 2/8/2024 7:40:48 PM | 2/8/2024 7:40 PM |
Contacts | Primary Contact | Update | Profile Change Request | Cox, Tammy
Pharmacy Director
Butte Silver Bow Primary Health Care
4064966033 | Cox, Tammy
Executive Director
Butte Silver Bow Primary Health Care
4064966018 | 2/8/2024 4:37 PM |
Details | Last Recertification Date | Update | Recertification | | 2/22/2023 2:23:30 PM | 2/22/2023 2:23 PM |
Details | State | Update | | Approved | Active | 4/1/2022 12:01 AM |
Contacts | Signed By | Insert | New Registration | | Davis, Michele K
CFO
Butte Silver Bow Primary Health Care, Inc
4064966025 | 3/1/2022 3:05 PM |
Details | 340B ID | Update | New Registration | | CH08327P | 3/1/2022 3:05 PM |
Dates | Participating Approval Date | Update | New Registration | | 3/1/2022 3:05:42 PM | 3/1/2022 3:05 PM |
Details | State | Update | New Registration | Pending | Approved | 3/1/2022 3:05 PM |
Dates | Signed By Date | Update | New Registration | | 3/1/2022 11:24:39 AM | 3/1/2022 3:05 PM |
Dates | Start Date | Update | New Registration | | 4/1/2022 12:00:00 AM | 3/1/2022 3:05 PM |
Addresses | Main Address | Insert | New Registration | |
1101 N Emmett Ave
Butte, MT 59701-8514 | 2/28/2022 7:24 PM |
Addresses | Billing Address | Insert | New Registration | | Butte-silver Bow Primary Health Care Clinic, Inc.
445 Centennial Ave.
Butte, MT 59701 | 2/28/2022 7:24 PM |
Contacts | Primary Contact | Insert | New Registration | | Cox, Tammy
Pharmacy Director
Butte Silver Bow Primary Health Care
4064966033 | 2/28/2022 7:24 PM |
Contacts | Authorizing Official | Insert | New Registration | | Davis, Michele K
CFO
Butte Silver Bow Primary Health Care, Inc
4064966025 | 2/28/2022 7:24 PM |
Details | Assistance Received From Date | Insert | New Registration | | | 2/28/2022 7:24 PM |
Details | Assistance Received To Date | Insert | New Registration | | | 2/28/2022 7:24 PM |
Details | Last Recertification Date | Insert | New Registration | | | 2/28/2022 7:24 PM |
Details | Grant Number | Insert | New Registration | | H80CS00799 | 2/28/2022 7:24 PM |
Details | 340B ID | Insert | New Registration | | | 2/28/2022 7:24 PM |
Details | Is Authorizing Official EHB Data | Insert | New Registration | | | 2/28/2022 7:24 PM |
Dates | Last Date That 340B Drugs Purchased | Insert | New Registration | | | 2/28/2022 7:24 PM |
Details | Medicare Provider Number | Insert | New Registration | | | 2/28/2022 7:24 PM |
Details | Entity Name | Insert | New Registration | | Butte-silver Bow Primary Health Care Clinic, Inc. | 2/28/2022 7:24 PM |
Details | NOFO Number | Insert | New Registration | | | 2/28/2022 7:24 PM |
Details | Program Code | Insert | New Registration | | CH | 2/28/2022 7:24 PM |
Details | Entity Subname | Insert | New Registration | | Kennedy Elementary Room #206 | 2/28/2022 7:24 PM |
Dates | Participating Approval Date | Insert | New Registration | | | 2/28/2022 7:24 PM |
Details | State | Insert | New Registration | | Pending | 2/28/2022 7:24 PM |
Dates | Registration Date | Insert | New Registration | | 2/28/2022 7:24:29 PM | 2/28/2022 7:24 PM |
Dates | Signed By Date | Insert | New Registration | | | 2/28/2022 7:24 PM |
Dates | Start Date | Insert | New Registration | | | 2/28/2022 7:24 PM |
Terminations | Termination Comments | Insert | New Registration | | | 2/28/2022 7:24 PM |
Terminations | Termination Date | Insert | New Registration | | | 2/28/2022 7:24 PM |
Terminations | Termination Effective Date | Insert | New Registration | | | 2/28/2022 7:24 PM |
Terminations | Termination Reason | Insert | New Registration | | | 2/28/2022 7:24 PM |