Covered Entity Details

SCH270051-34 KALISPELL REGIONAL MEDICAL CENTER (Terminated) - information as of 5/3/2025 11:33:13 PM

Main Details

Name

KALISPELL REGIONAL MEDICAL CENTER

Subdivision Name

Montana Children’s Maternal-Fetal Medicine

Type

Sole Community Hospital

Rural

Yes

340B ID

SCH270051-34

Medicare Provider Number

270051

Outpatient Facility Provider Number

Additional Details

Current Program Status

Terminated

Registration Date

4/11/2016

Participating Start Date

7/1/2016

Participating Approval Date

5/10/2016

Last Recertification Date

9/14/2020

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

210 Sunnyview Lane Suite 103
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	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

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
Addresses	Main Address	Update	Recertification	210 SUNNYVIEW LANE STE 103 Montana Children’s Maternal-Fetal Medicine KALISPELL, MT 59901-3128	210 Sunnyview Lane Suite 103 Kalispell, MT 59901	9/14/2020 11:12 AM
Details	Last Recertification Date	Update	Recertification	8/27/2019 11:07:21 AM	9/14/2020 11:12:39 AM	9/14/2020 11:12 AM
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	4/20/2020 11:45 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
Addresses	Main Address	Update	Change Request	210 SUNNYVIEW LANE STE 103 MONTANA PERINATAL CENTER KALISPELL, MT 59901-3128	210 SUNNYVIEW LANE STE 103 Montana Children’s Maternal-Fetal Medicine KALISPELL, MT 59901-3128	10/10/2019 4:13 PM
Details	Entity Subname	Update	Change Request	MONTANA PERINATAL CENTER	Montana Children’s Maternal-Fetal Medicine	10/10/2019 4:13 PM
Details	Last Recertification Date	Update	Recertification	8/16/2018 12:07:29 PM	8/27/2019 11:07:21 AM	8/27/2019 11:07 AM
Details	Last Recertification Date	Update	Recertification	11/7/2017 10:27:50 AM	8/16/2018 12:07:29 PM	8/16/2018 12:07 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	8/16/2016 12:00:00 AM	11/7/2017 10:27:50 AM	11/7/2017 10:27 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	Signed By	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	Signed By	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			210 SUNNYVIEW LANE STE 103 MONTANA PERINATAL CENTER KALISPELL, MT 59901-3128	10/20/2016 6:00 PM
Details	Last Recertification Date	Update			8/16/2016 12:00:00 AM	8/16/2016 5:00 PM
Dates	Participating Approval Date	Update			5/10/2016 12:00:00 AM	5/10/2016 7:01 PM
Details	State	Update		Pending	Active	5/10/2016 7:01 PM
Dates	Start Date	Update			7/1/2016 12:00:00 AM	5/10/2016 7:01 PM
Details	340B ID	Update		OUTPATIENT_ONLINE_REG_59583	SCH270051-34	4/29/2016 2:03 PM
Details	Entity Subname	Update		KALISPELL REGIONAL MEDICAL CENTER I - MONTANA PERINATAL CENTER	MONTANA PERINATAL CENTER	4/29/2016 2:03 PM
Details	Entity Subname	Update		KALISPELL REGIONAL MEDICAL CENTER I	KALISPELL REGIONAL MEDICAL CENTER I - MONTANA PERINATAL CENTER	4/28/2016 12:52 PM
Details	340B ID	Update			OUTPATIENT_ONLINE_REG_59583	4/11/2016 2:49 PM
Details	Last Recertification Date	Insert				4/11/2016 2:49 PM
Details	Grant Number	Insert				4/11/2016 2:49 PM
Details	340B ID	Insert				4/11/2016 2:49 PM
Details	Is Authorizing Official EHB Data	Insert				4/11/2016 2:49 PM
Dates	Last Date That 340B Drugs Purchased	Insert				4/11/2016 2:49 PM
Details	Medicare Provider Number	Insert			270051	4/11/2016 2:49 PM
Details	Entity Name	Insert			KALISPELL REGIONAL MEDICAL CENTER	4/11/2016 2:49 PM
Details	Program Code	Insert			SCH	4/11/2016 2:49 PM
Details	Entity Subname	Insert			KALISPELL REGIONAL MEDICAL CENTER I	4/11/2016 2:49 PM
Dates	Participating Approval Date	Insert				4/11/2016 2:49 PM
Details	State	Insert			Pending	4/11/2016 2:49 PM
Dates	Registration Date	Insert			4/11/2016 12:00:00 AM	4/11/2016 2:49 PM
Dates	Signed By Date	Insert			4/11/2016 12:00:00 AM	4/11/2016 2:49 PM
Dates	Start Date	Insert				4/11/2016 2:49 PM
Terminations	Termination Comments	Insert				4/11/2016 2:49 PM
Terminations	Termination Date	Insert				4/11/2016 2:49 PM
Terminations	Termination Effective Date	Insert				4/11/2016 2:49 PM
Terminations	Termination Reason	Insert				4/11/2016 2:49 PM