Provider Demographics
NPI:1447621214
Name:BIG SKY MOBILE IMAGING, LLC
Entity type:Organization
Organization Name:BIG SKY MOBILE IMAGING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PURDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-291-1527
Mailing Address - Street 1:390 PURDY DR
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:MT
Mailing Address - Zip Code:59917-9492
Mailing Address - Country:US
Mailing Address - Phone:406-291-1527
Mailing Address - Fax:
Practice Address - Street 1:390 PURDY DR
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:MT
Practice Address - Zip Code:59917-9492
Practice Address - Country:US
Practice Address - Phone:406-291-1527
Practice Address - Fax:406-206-5015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-19
Last Update Date:2020-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier