Covered Entity Details

SCH270051-00 KALISPELL REGIONAL MEDICAL CENTER (Terminated) - information as of 4/30/2025 10:51:24 PM

Main Details

Name

KALISPELL REGIONAL MEDICAL CENTER

Subdivision Name

Type

Sole Community Hospital

Rural

Yes

340B ID

SCH270051-00

Medicare Provider Number

270051

Additional Details

Current Program Status

Terminated

Registration Date

8/26/2010

Participating Start Date

9/24/2010

Participating Approval Date

8/30/2010

Last Recertification Date

9/11/2020

Termination Date
Termination Reason

1/1/2021
Change of covered entity type

Contacts

Authorizing Official

Kalispell Regional Healthcare
Craig O Boyer, Chief Financial Officer
(406) 752-5111

Primary Contact

Kalispell Regional Medical Center
Tera Thorderson, Pharmacist
(406) 607-8004

Addresses

Street Address

310 SUNNYVIEW LANE
KALISPELL, MT 59901

Billing Address
Same as Street Address

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
No

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Termination Date	Last Updated On
Contract Detail	ALBERTSONS LLC	OSCO PHARMACY #18	900 WEST IDAHO	KALISPELL	MT	59901	07/06/2020	10/01/2020	01/01/2021	01/01/2021
Contract Detail	BIGFORK DRUG INC.	8111 MT HIGHWAY 35		BIGFORK	MT	59911-3588	01/08/2020	04/01/2020	01/01/2021	01/01/2021
Contract Detail	DIPLOMAT SPECIALTY PHARMACY	4100 S SAGINAW ST	STE D	FLINT	MI	48507-2683	01/17/2017	04/01/2017	12/13/2019	12/13/2019
Contract Detail	DIPLOMAT SPECIALTY PHARMACY OF PHOENIX,	DIPLOMAT SPECIALTY PHARMACY	485 N. JUNIPER DR	CHANDLER	AZ	85226	07/12/2019	10/01/2019	12/13/2019	12/13/2019
Contract Detail	DIPLOMAT SPECIALTY PHARMACY OF SOUTHERN	DIPLOMAT SPECIALTY PHARMACY	1809 EXCISE AVENUE SUITE 204-208	ONTARIO	CA	91761	01/17/2017	04/01/2017	07/31/2019	07/31/2019
Contract Detail	LOGAN HEALTH - WHITEFISH	DBA LOGAN HEALTH PHARMACY - COLUMBIA FAL	2100 9TH ST W	COLUMBIA FALLS	MT	59912	10/14/2019	01/01/2020	01/01/2021	01/01/2021
Contract Detail	LOGAN HEALTH PHARMACY CLINICAL	200 CONWAY DR		KALISPELL	MT	59901	01/01/2011	01/01/2011	01/01/2021	01/01/2021
Contract Detail	MEDICAL ARTS PHARMACY		209 CONWAY DRIVE	KALISPELL	MT	59901	01/06/2017	04/01/2017	01/01/2021	01/01/2021
Contract Detail	SAFEWAY INC	SAFEWAY PHARMACY #2106	6580 HIGHWAY 93 SOUTH	WHITEFISH	MT	59937	07/06/2020	10/01/2020	01/01/2021	01/01/2021
Contract Detail	SMITH'S FOOD/DRUG CENTERS	SMITH'S PHARMACY #172	195 3RD AVENUE NE	KALISPELL	MT	59901	07/06/2020	10/01/2020	01/01/2021	01/01/2021
Contract Detail	SMITH'S PHARMACY # 168	419 NUCLEUS AVE.	PO BOX 159	COLUMBIA FALLS	MT	59912	07/06/2020	10/01/2020	01/01/2021	01/01/2021
Contract Detail	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	10/09/2015	01/01/2016	01/01/2021	01/01/2021
Contract Detail	WAL-MART PHARMACY 10-2259	170 HUTTON RANCH ROAD		KALISPELL	MT	59901	10/09/2015	01/01/2016	01/01/2021	01/01/2021
Contract Detail	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	10/09/2015	01/01/2016	01/01/2021	01/01/2021
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 09242	40 W IDAHO ST	KALISPELL	MT	59901	10/07/2015	01/01/2016	06/19/2017	06/27/2017
Contract Detail	WALGREEN CO.	DBA: WALGREENS #12347	700 13TH ST E	WHITEFISH	MT	59937	10/07/2015	01/01/2016	06/19/2017	06/27/2017
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 09242	40 W IDAHO ST	KALISPELL	MT	59901	10/14/2019	01/01/2020	01/01/2021	01/01/2021
Contract Detail	WALGREEN CO.	DBA: WALGREENS #12347	700 13TH ST E	WHITEFISH	MT	59937	01/08/2020	04/01/2020	01/01/2021	01/01/2021
Contract Detail	WALGREENS SPECIALTY PHARMACY, LLC	ALLIANCERX WALGREENS PRIME #12314	9775 SW GEMINI DR, STE 1	BEAVERTON	OR	97008	10/14/2019	01/01/2020	01/01/2021	01/01/2021

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
SCH270051-01	Child	SCH	KALISPELL REGIONAL MEDICAL CENTER	DIABETES CARE AND PREVENTION PROGRAM	430 Windward Way, Suite 100	Kalispell	MT	Terminated
SCH270051-02	Child	SCH	KALISPELL REGIONAL MEDICAL CENTER	Northwest Specialists - Endocrinology	430 Windward Way	Kalispell	MT	Terminated
SCH270051-04	Child	SCH	KALISPELL REGIONAL MEDICAL CENTER	THE BASS BREAST CENTER	310 SUNNYVIEW LANE	KALISPELL	MT	Terminated
SCH270051-05	Child	SCH	KALISPELL REGIONAL MEDICAL CENTER	PATHWAYS TREATMENT CENTER	200 HERITAGE WAY	KALISPELL	MT	Terminated
SCH270051-06	Child	SCH	KALISPELL REGIONAL MEDICAL CENTER	Northwest Montana Radiation Oncology	343 Sunnyview Lane	Kalispell	MT	Terminated
SCH270051-07	Child	SCH	KALISPELL REGIONAL MEDICAL CENTER	BIG SKY FAMILY MEDICINE	160 Heritage Way, Suite 202	KALISPELL	MT	Terminated
SCH270051-08	Child	SCH	KALISPELL REGIONAL MEDICAL CENTER	ROCKY MOUNTAIN HEART AND LUNG	350 HERITAGE WAY	KALISPELL	MT	Terminated
SCH270051-09	Child	SCH	KALISPELL REGIONAL MEDICAL CENTER	Northwest Montana Surgical Associates	1333 Surgical Services Drive	Kalispell	MT	Terminated
SCH270051-10	Child	SCH	KALISPELL REGIONAL MEDICAL CENTER	Brendan House	350 Conway Drive	Kalispell	MT	Terminated
SCH270051-11	Child	SCH	KALISPELL REGIONAL MEDICAL CENTER	Lake County Home Options Home Health	711 Main Street SW	Ronan	MT	Terminated
SCH270051-12	Child	SCH	KALISPELL REGIONAL MEDICAL CENTER	Northwest Oncology and Hematology	350 Heritage Way, Suite 1100	Kalispell	MT	Terminated
SCH270051-13	Child	SCH	KALISPELL REGIONAL MEDICAL CENTER	Family Health Care	1287 Burns Way	Kalispell	MT	Terminated
SCH270051-14	Child	SCH	KALISPELL REGIONAL MEDICAL CENTER	Home Options Home Health	275 Corporate Drive, Suite 600	Kalispell	MT	Terminated
SCH270051-15	Child	SCH	KALISPELL REGIONAL MEDICAL CENTER	Home Options Hospice	275 Corporate Drive, Suite 600	Kalispell	MT	Terminated
SCH270051-16	Child	SCH	KALISPELL REGIONAL MEDICAL CENTER	Kalispell Gastroenterology	75 Claremont Street, Suite F	Kalispell	MT	Terminated
SCH270051-17	Child	SCH	KALISPELL REGIONAL MEDICAL CENTER	Northwest Specialists	430 Windward Way, Suite 100	Kalispell	MT	Terminated
SCH270051-18	Child	SCH	KALISPELL REGIONAL MEDICAL CENTER	Peri & Neonatal Services at KRMC	310 Sunnyview Lane	Kalispell	MT	Terminated
SCH270051-19	Child	SCH	KALISPELL REGIONAL MEDICAL CENTER	Bigfork Medical Clinic	8299 MT Hwy 35	Bigfork	MT	Terminated
SCH270051-20	Child	SCH	KALISPELL REGIONAL MEDICAL CENTER	Woodland Clinic	705 6th Avenue East	Kalispell	MT	Terminated
SCH270051-21	Child	SCH	KALISPELL REGIONAL MEDICAL CENTER	Turtle Bay	7325 US-93	Lakeside	MT	Terminated
SCH270051-22	Child	SCH	KALISPELL REGIONAL MEDICAL CENTER	Northwest Family Medicine	70 Village Loop	Kalispell	MT	Terminated
SCH270051-23	Child	SCH	KALISPELL REGIONAL MEDICAL CENTER	Family Health Care Columbia Falls Clinic	1850 9th Street W.	Columbia Falls	MT	Terminated
SCH270051-24	Child	SCH	KALISPELL REGIONAL MEDICAL CENTER	Northwest Hospitalists	310 Sunnyview Lane	Kalispell	MT	Terminated
SCH270051-25	Child	SCH	KALISPELL REGIONAL MEDICAL CENTER	Wound Ostomy Center	210 Sunnyview Lane, Suite 105	Kalispell	MT	Terminated
SCH270051-26	Child	SCH	KALISPELL REGIONAL MEDICAL CENTER	Sunnyview Pediatrics	1273 Burns Way	Kalispell	MT	Terminated
SCH270051-27	Child	SCH	KALISPELL REGIONAL MEDICAL CENTER	Eureka Prompt Care	304 Osloski Road	Eureka	MT	Terminated
SCH270051-28	Child	SCH	KALISPELL REGIONAL MEDICAL CENTER	Eureka Therapy	298 Osloski Road	Eureka	MT	Terminated
SCH270051-29	Child	SCH	KALISPELL REGIONAL MEDICAL CENTER	Neuroscience & Spine Institute - Neurosurgery	200 Commons Way	Kalispell	MT	Terminated
SCH270051-30	Child	SCH	KALISPELL REGIONAL MEDICAL CENTER	Neuroscience and Spine Institute - Neurology	200 Commons Way	Kalispell	MT	Terminated
SCH270051-31	Child	SCH	KALISPELL REGIONAL MEDICAL CENTER	Kalispell Medical Offices & Bone Health	1280 Burns Way	Kalispell	MT	Terminated
SCH270051-32	Child	SCH	KALISPELL REGIONAL MEDICAL CENTER	Westshore Medical Clinic	306 Stoner Loop	Lakeside	MT	Terminated
SCH270051-33	Child	SCH	KALISPELL REGIONAL MEDICAL CENTER	GLACIER VIEW PLASTIC SURGERY	60 FOUR MILE DRIVE STE 10	KALISPELL	MT	Terminated
SCH270051-34	Child	SCH	KALISPELL REGIONAL MEDICAL CENTER	Montana Children’s Maternal-Fetal Medicine	210 Sunnyview Lane Suite 103	Kalispell	MT	Terminated
SCH270051-35	Child	SCH	KALISPELL REGIONAL MEDICAL CENTER	Department of Physical Medicine & Rehabilitation	205 Sunnyview Lane	Kalispell	MT	Terminated
SCH270051-36	Child	SCH	KALISPELL REGIONAL MEDICAL CENTER	Rocky Mountain Heart & Lung - South	1821 South Ave West, Suite 202	MISSOULA	MT	Terminated
SCH270051-37	Child	SCH	KALISPELL REGIONAL MEDICAL CENTER	Rocky Mountain Heart & Lung - Pulmonology	350 Heritage Way	Kalispell	MT	Terminated
SCH270051-38	Child	SCH	KALISPELL REGIONAL MEDICAL CENTER	DR. GINA NELSON OB/GYN	210 SUNNYVIEW LANE STE 104	KALISPELL	MT	Terminated
SCH270051-39	Child	SCH	KALISPELL REGIONAL MEDICAL CENTER	SLEEP LAB	200 COMMONS WAY, SUITE A	KALISPELL	MT	Terminated
SCH270051-40	Child	SCH	KALISPELL REGIONAL MEDICAL CENTER	GLACIER ONCOLOGY	75 CLAREMONT, SUITE E	KALISPELL	MT	Terminated
SCH270051-41	Child	SCH	KALISPELL REGIONAL MEDICAL CENTER	Pediatric Oncology - Montana Children's Specialists	350 Heritage Way	KALISPELL	MT	Terminated
SCH270051-42	Child	SCH	KALISPELL REGIONAL MEDICAL CENTER	Pediatric Cardiology - Montana Children's Specialists	350 Heritage Way	KALISPELL	MT	Terminated
SCH270051-43	Child	SCH	KALISPELL REGIONAL MEDICAL CENTER	Pediatric Endocrinology and Diabetes - Montana Children's Specialists	202 Conway Drive	Kalispell	MT	Terminated
SCH270051-44	Child	SCH	KALISPELL REGIONAL MEDICAL CENTER	Greater Flathead Renal	75 Claremont, Suite H	Kalispell	MT	Terminated
SCH270051-45	Child	SCH	KALISPELL REGIONAL MEDICAL CENTER	KALISPELL OB/GYN	210 SUNNYVIEW LANE, SUITE 201	KALISPELL	MT	Terminated
SCH270051-46	Child	SCH	KALISPELL REGIONAL MEDICAL CENTER	Pediatric Gastroenterology - Montana Children's Specialists	202 Conway Drive	Kalispell	MT	Terminated
SCH270051-47	Child	SCH	KALISPELL REGIONAL MEDICAL CENTER	FAMILYBORN MATERNITY AND WOMEN'S HEALTH - OB GYN	210 Sunnyview Lane, Suite 101	Kalispell	MT	Terminated
SCH270051-48	Child	SCH	KALISPELL REGIONAL MEDICAL CENTER	CLINIC PEDIATRIC HOSPITALIST - PEDIATRIC	310 Sunnyview Lane	Kalispell	MT	Terminated
SCH270051-49	Child	SCH	KALISPELL REGIONAL MEDICAL CENTER	Pediatric Surgery - Montana Children's Specialists	202 Conway Drive	Kalispell	MT	Terminated
SCH270051-50	Child	SCH	KALISPELL REGIONAL MEDICAL CENTER	Family Health Care - South Annex	1250 Burns Way, Suite 1	Kalispell	MT	Terminated
SCH270051-51	Child	SCH	KALISPELL REGIONAL MEDICAL CENTER	KRMC Outpatient Surgery Center	111 Sunnyview Lane, Suite 101	Kalispell	MT	Terminated
SCH270051-52	Child	SCH	KALISPELL REGIONAL MEDICAL CENTER	POLSON HEALTH	106 RIDGEWATER DR	POLSON	MT	Terminated
SCH270051-53	Child	SCH	KALISPELL REGIONAL MEDICAL CENTER	POLSON PROCEDURES - AMBULATORY SURGICAL CENTER	106 Ridgewater Drive, Suite B	Polson	MT	Terminated
SCH270051-54	Child	SCH	KALISPELL REGIONAL MEDICAL CENTER	Pediatric Neurology - Montana Children's Specialists - Pediatric Neurology	202 Conway Drive	Kalispell	MT	Terminated
SCH270051-55	Child	SCH	KALISPELL REGIONAL MEDICAL CENTER	Pediatric Neurosurgery - Montana Children's Specialists - Pediatric Neurosurgery	202 Conway Drive	Kalispell	MT	Terminated

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	State	Update		To Be Terminated	Terminated	1/1/2021 12:01 AM
Dates	Last Date That 340B Drugs Purchased	Update	Hospital Type Change Request		1/1/2021 12:00:00 AM	11/3/2020 10:47 AM
Details	State	Update	Hospital Type Change Request	Active	To Be Terminated	11/3/2020 10:47 AM
Terminations	Termination Date	Update	Hospital Type Change Request		1/1/2021 12:00:00 AM	11/3/2020 10:47 AM
Terminations	Termination Effective Date	Update	Hospital Type Change Request		1/1/2021 12:00:00 AM	11/3/2020 10:47 AM
Terminations	Termination Reason	Update	Hospital Type Change Request		Change of covered entity type	11/3/2020 10:47 AM
Details	Last Recertification Date	Update	Recertification	8/31/2019 7:49:27 AM	9/11/2020 2:47:35 PM	9/11/2020 2:47 PM
Contacts	Authorizing Official	Update	Change Request	Wilson, Deborah M Chief Operating Officer Kalispell Regional 4067521724	Boyer, Craig O Chief Financial Officer Kalispell Regional Healthcare 4067525111	7/28/2020 9:44 AM
Contacts	Primary Contact	Update	Profile Change Request	Thorderson, Tera Pharmacist Kalispell Regional Medical Center 4067517600	Thorderson, Tera Pharmacist Kalispell Regional Medical Center 4066078004	7/1/2020 1:02 PM
Contacts	Primary Contact	Update	Change Request	Taylor, Dennice J Accountant II, 340b Analyst Kalispell Regional 4067516560	Thorderson, Tera Pharmacist Kalispell Regional Medical Center 4067517600	4/15/2020 11:32 AM
Contacts	Primary Contact	Update	Profile Change Request	Hamman, Dennice J Pharmacy Analyst Kalispell Regional 4067516560	Taylor, Dennice J Accountant II, 340b Analyst Kalispell Regional 4067516560	12/13/2019 2:37 PM
Details	Last Recertification Date	Update	Recertification	8/16/2018 12:10:39 PM	8/31/2019 7:49:27 AM	8/31/2019 7:49 AM
Details	Last Recertification Date	Update	Recertification	11/8/2017 2:32:19 PM	8/16/2018 12:10:39 PM	8/16/2018 12:10 PM
Contacts	Authorizing Official	Update	Change Request	PEARCE, CHARLES C.F.I.O. Kalispell Regional 4067521724	Wilson, Deborah M Chief Operating Officer Kalispell Regional 4067521724	4/2/2018 8:24 AM
Details	Last Recertification Date	Update	Recertification	10/25/2017 11:36:16 AM	11/8/2017 2:32:19 PM	11/8/2017 2:32 PM
Details	Last Recertification Date	Update	Recertification	8/16/2016 12:00:00 AM	10/25/2017 11:36:16 AM	10/25/2017 11:36 AM
Contacts	Primary Contact	Update	Recertification	Hamman, Dennice Pharmacy Analyst Kalispell Regional 4067516560	Hamman, Dennice J Pharmacy Analyst Kalispell Regional 4067516560	10/25/2017 10:32 AM
Contacts	Authorizing Official	Update		PEARCE, CHARLES C.F.I.O. 4067521724	PEARCE, CHARLES C.F.I.O. Kalispell Regional 4067521724	9/19/2017 4:02 PM
Contacts	Primary Contact	Update		Hamman, Dennice Pharmacy Analyst 4067516560	Hamman, Dennice Pharmacy Analyst Kalispell Regional 4067516560	9/19/2017 11:57 AM
Contacts	Authorizing Official	Insert			PEARCE, CHARLES C.F.I.O. 4067521724	6/28/2017 12:45 PM
Contacts	Primary Contact	Insert			Hamman, Dennice Pharmacy Analyst 4067516560	6/28/2017 12:45 PM
Addresses	Main Address	Insert			310 SUNNYVIEW LANE KALISPELL, MT 59901	10/20/2016 6:00 PM
Details	Last Recertification Date	Update		8/6/2015 12:00:00 AM	8/16/2016 12:00:00 AM	8/16/2016 5:00 PM
Details	Last Recertification Date	Update		9/4/2014 12:00:00 AM	8/6/2015 12:00:00 AM	8/12/2015 11:51 AM
Details	Last Recertification Date	Update		9/5/2013 12:00:00 AM	9/4/2014 12:00:00 AM	9/4/2014 11:52 AM
Details	Last Recertification Date	Update		7/1/2012 12:00:00 AM	9/5/2013 12:00:00 AM	9/5/2013 5:40 PM
Details	Last Recertification Date	Update			7/1/2012 12:00:00 AM	4/25/2012 7:28 AM
Details	Last Recertification Date	Insert				9/24/2010 9:41 AM
Details	Grant Number	Insert				9/24/2010 9:41 AM
Details	340B ID	Insert			SCH270051-00	9/24/2010 9:41 AM
Details	Is Authorizing Official EHB Data	Insert				9/24/2010 9:41 AM
Dates	Last Date That 340B Drugs Purchased	Insert				9/24/2010 9:41 AM
Details	Medicare Provider Number	Insert			270051	9/24/2010 9:41 AM
Details	Entity Name	Insert			KALISPELL REGIONAL MEDICAL CENTER	9/24/2010 9:41 AM
Details	Program Code	Insert			SCH	9/24/2010 9:41 AM
Details	Entity Subname	Insert				9/24/2010 9:41 AM
Dates	Participating Approval Date	Insert			8/30/2010 12:00:00 AM	9/24/2010 9:41 AM
Details	State	Insert			Active	9/24/2010 9:41 AM
Dates	Registration Date	Insert			8/26/2010 12:00:00 AM	9/24/2010 9:41 AM
Dates	Signed By Date	Insert			8/26/2010 12:00:00 AM	9/24/2010 9:41 AM
Dates	Start Date	Insert			9/24/2010 12:00:00 AM	9/24/2010 9:41 AM
Terminations	Termination Comments	Insert				9/24/2010 9:41 AM
Terminations	Termination Date	Insert				9/24/2010 9:41 AM
Terminations	Termination Effective Date	Insert				9/24/2010 9:41 AM
Terminations	Termination Reason	Insert				9/24/2010 9:41 AM