Provider Demographics
NPI:1669502316
Name:CONFEDERATED SALISH & KOOTENAI TRIBES OF THE FLATHEAD RESERVATION
Entity type:Organization
Organization Name:CONFEDERATED SALISH & KOOTENAI TRIBES OF THE FLATHEAD RESERVATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JESSI
Authorized Official - Middle Name:
Authorized Official - Last Name:CAHOON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-745-3525
Mailing Address - Street 1:PO BOX 880
Mailing Address - Street 2:
Mailing Address - City:ST IGNATIUS
Mailing Address - State:MT
Mailing Address - Zip Code:59865-0880
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:35401 MISSION DRIVE
Practice Address - Street 2:
Practice Address - City:SAINT IGNATIUS
Practice Address - State:MT
Practice Address - Zip Code:59865
Practice Address - Country:US
Practice Address - Phone:406-745-3525
Practice Address - Fax:406-745-4721
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CONFEDERATED SALISH & KOOTENAI TRIBES OF THE FLATHEAD RESERVATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-06
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332800000XSuppliersIndian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0309604Medicaid
2706438OtherOTHER ID NUMBER-COMMERCIAL NUMBER
2706438OtherOTHER ID NUMBER-COMMERCIAL NUMBER
271810Medicare ID - Type Unspecified