Covered Entity Details

CAH531309-00 North Big Horn Hospital District (Active) - information as of 6/24/2025 12:04:07 AM

Main Details

Name

North Big Horn Hospital District

Subdivision Name

Type

Critical Access Hospital

Rural

340B ID

CAH531309-00

Medicare Provider Number

531309

Additional Details

Current Program Status

Active

Registration Date

8/18/2011

Participating Start Date

10/1/2011

Participating Approval Date

9/19/2011

Last Recertification Date

8/31/2024

Contacts

Authorizing Official

North Big Horn Hospital District
Eric Connell, CEO
(307) 548-5200

Primary Contact

North Big Horn Hospital
Gareth Robertson, Pharmacist
(307) 548-5235

Addresses

Street Address

1115 Lane 12
Lovell, WY 82431

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	Carve-In Effective Date	Termination Date	Last Updated On
Contract Detail	LOVELL DRUG	ATTN: BRENT B. REASCH, PERSON IN CHARGE	164 E MAIN ST PO BOX 847	LOVELL	WY	82431	04/15/2013	07/01/2013			04/15/2013
Contract Detail	POWELL DRUG	140 N BENT ST		POWELL	WY	82435	10/15/2018	01/01/2019			01/01/2019

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
CAH531309-01	Child	CAH	North Big Horn Hospital District	North Big Horn Hospital Clinic	1115 Lane 12	Lovell	WY	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	9/25/2023 11:36:14 AM	8/31/2024 8:25:47 AM	8/31/2024 8:25 AM
Details	Last Recertification Date	Update	Recertification	9/6/2022 7:59:10 AM	9/25/2023 11:36:14 AM	9/25/2023 11:36 AM
Details	Last Recertification Date	Update	Recertification	8/17/2021 10:16:43 AM	9/6/2022 7:59:10 AM	9/6/2022 7:59 AM
Details	Last Recertification Date	Update	Recertification	9/3/2020 2:44:52 PM	8/17/2021 10:16:43 AM	8/17/2021 10:16 AM
Contacts	Authorizing Official	Update	Change Request	Schroeder, Rick CEO North Big Horn Hospital District 3075485203	Connell, Eric CEO North Big Horn Hospital District 3075485200	4/8/2021 10:29 AM
Details	Last Recertification Date	Update	Recertification	9/10/2019 7:47:41 AM	9/3/2020 2:44:52 PM	9/3/2020 2:44 PM
Details	Last Recertification Date	Update	Recertification	9/10/2018 10:55:40 AM	9/10/2019 7:47:41 AM	9/10/2019 7:47 AM
Details	Last Recertification Date	Update	Recertification	11/29/2017 12:53:51 PM	9/10/2018 10:55:40 AM	9/10/2018 10:55 AM
Details	Last Recertification Date	Update	Recertification	8/15/2016 12:00:00 AM	11/29/2017 12:53:51 PM	11/29/2017 12:53 PM
Contacts	Authorizing Official	Update		Schroeder, Rick CEO 3075485203	Schroeder, Rick CEO North Big Horn Hospital District 3075485203	11/29/2017 11:14 AM
Contacts	Signed By	Update		Schroeder, Rick CEO 3075485203	Schroeder, Rick CEO North Big Horn Hospital District 3075485203	11/29/2017 11:14 AM
Contacts	Primary Contact	Update		Robertson, Gareth Pharmacist 3075485235	Robertson, Gareth Pharmacist North Big Horn Hospital 3075485235	10/10/2017 10:22 AM
Addresses	Main Address	Insert			1115 Lane 12 Lovell, WY 82431	8/15/2016 1:02 PM
Contacts	Primary Contact	Update		Casey, Trevor Pharmacist 3075485235	Robertson, Gareth Pharmacist 3075485235	8/15/2016 1:02 PM
Contacts	Authorizing Official	Insert			Schroeder, Rick CEO 3075485203	8/15/2016 1:02 PM
Contacts	Signed By	Insert			Schroeder, Rick CEO 3075485203	8/15/2016 1:02 PM
Details	Last Recertification Date	Update		8/14/2015 12:00:00 AM	8/15/2016 12:00:00 AM	8/15/2016 1:02 PM
Details	Last Recertification Date	Update		8/19/2014 12:00:00 AM	8/14/2015 12:00:00 AM	8/14/2015 11:32 AM
Details	Last Recertification Date	Update		9/6/2013 12:00:00 AM	8/19/2014 12:00:00 AM	8/19/2014 11:10 AM
Details	Last Recertification Date	Update			9/6/2013 12:00:00 AM	9/6/2013 9:55 AM
Contacts	Primary Contact	Insert			Casey, Trevor Pharmacist 3075485235	12/19/2011 5:13 PM
Dates	Participating Approval Date	Update			9/19/2011 12:00:00 AM	9/19/2011 3:29 PM
Details	State	Update		Pending	Active	9/19/2011 3:29 PM
Dates	Start Date	Update			10/1/2011 12:00:00 AM	9/15/2011 10:13 AM
Details	340B ID	Update		ONLINE_REG	CAH531309-00	9/13/2011 1:33 AM
Details	Last Recertification Date	Insert				8/18/2011 1:49 PM
Details	Grant Number	Insert				8/18/2011 1:49 PM
Details	340B ID	Insert			ONLINE_REG	8/18/2011 1:49 PM
Details	Is Authorizing Official EHB Data	Insert				8/18/2011 1:49 PM
Dates	Last Date That 340B Drugs Purchased	Insert				8/18/2011 1:49 PM
Details	Medicare Provider Number	Insert			531309	8/18/2011 1:49 PM
Details	Entity Name	Insert			North Big Horn Hospital District	8/18/2011 1:49 PM
Details	Program Code	Insert			CAH	8/18/2011 1:49 PM
Details	Entity Subname	Insert				8/18/2011 1:49 PM
Dates	Participating Approval Date	Insert				8/18/2011 1:49 PM
Details	State	Insert			Pending	8/18/2011 1:49 PM
Dates	Registration Date	Insert			8/18/2011 12:00:00 AM	8/18/2011 1:49 PM
Dates	Signed By Date	Insert			8/18/2011 12:00:00 AM	8/18/2011 1:49 PM
Dates	Start Date	Insert				8/18/2011 1:49 PM
Terminations	Termination Comments	Insert				8/18/2011 1:49 PM
Terminations	Termination Date	Insert				8/18/2011 1:49 PM
Terminations	Termination Effective Date	Insert				8/18/2011 1:49 PM
Terminations	Termination Reason	Insert				8/18/2011 1:49 PM