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FQHC638613 Blackfeet Tribal Health System (Active)
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Main Details
Name
Blackfeet Tribal Health System
Subdivision Name
Blackfeet Tribal Public Health Clinic
Type
Tribal Contract/Compact with IHS (P.L. 93-638)
340B ID
FQHC638613
Additional Details
Current Program Status
Active
Registration Date
4/11/2024
Participating Start Date
7/1/2024
Participating Approval Date
4/23/2024
Last Recertification Date
2/11/2025
Contacts
Authorizing Official
Blackfeet Tribal Public Health Clinic
Rosaula Dacumos La PINE, FNP
(406) 338-2122
Primary Contact
Blackfeet Tribal Public Health Clinic
Jace Racine, Public Health Administrator
(406) 338-2122
Addresses
Street Address
215 2nd Street SW
Browning, MT 59417
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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