Covered Entity Details

CAH271336-05 Logan Health - Whitefish (Active) - information as of 5/5/2025 11:52:32 PM

Main Details

Name

Logan Health - Whitefish

Subdivision Name

Logan Health Behavioral Health Clinic - Whitefish

Type

Critical Access Hospital

Rural

Yes

340B ID

CAH271336-05

Medicare Provider Number

271336

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

4/9/2019

Participating Start Date

7/1/2019

Participating Approval Date

4/22/2019

Last Recertification Date

8/14/2024

Contacts

Authorizing Official

Logan Health-Whitefish
Kevin Abel, President
(406) 863-3500

Primary Contact

Logan Health-Whitefish
Andrew Matulionis, Director of Pharmacy
(406) 863-3510

Addresses

Street Address

2004 HOSPITAL WAY
WHITEFISH, MT 59937

Billing Address

Logan Health - Whitefish
1600 HOSPITAL WAY
WHITEFISH, MT 59937

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

Shipping Address 1

Logan Health - Whitefish
1600 HOSPITAL WAY
WHITEFISH, MT 59937

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
CAH271336-01	Child	CAH	Logan Health - Whitefish	Logan Health Primary Care - Eureka	304 OSLOSKI RD	EUREKA	MT	Active
CAH271336-02	Child	CAH	NORTH VALLEY HOSPITAL	NORTH VALLEY PROFESSIONAL CENTER	2165 9TH STREET WEST	COLUMBIA FALLS	MT	Terminated
CAH271336-03	Child	CAH	NORTH VALLEY HOSPITAL	NORTH VALLEY HOSPITAL INC - EUREKA HEALTHCARE PRIMARY CARE	298 OSLASKI RD	EUREKA	MT	Terminated
CAH271336-04	Child	CAH	Logan Health - Whitefish	Logan Health Primary Care - Columbia Falls	1675 TALBOT RD	COLUMBIA FALLS	MT	Active
CAH271336-05	Child	CAH	Logan Health - Whitefish	Logan Health Behavioral Health Clinic - Whitefish	2004 HOSPITAL WAY	WHITEFISH	MT	Active
CAH271336-06	Child	CAH	Logan Health - Whitefish	Logan Health Therapeutic & Diagnostic Services - Eureka	304 OSLOSKI RD	EUREKA	MT	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	8/28/2023 6:39:06 PM	8/14/2024 12:10:41 PM	8/14/2024 12:10 PM
Details	Last Recertification Date	Update	Recertification	8/25/2022 11:15:40 AM	8/28/2023 6:39:06 PM	8/28/2023 6:39 PM
Contacts	Authorizing Official	Update	Change Request	Richhart, David Chief Financial Officer Logan Health-Whitefish 4068639826	Abel, Kevin President Logan Health-Whitefish 4068633500	2/17/2023 9:39 AM
Contacts	Authorizing Official	Update	Change Request	Richhart, David Chief Financial Officer NORTH VALLEY HOSPITAL, INC. 4068639826	Richhart, David Chief Financial Officer Logan Health-Whitefish 4068639826	9/7/2022 12:03 PM
Contacts	Primary Contact	Update	Recertification	Matulionis, Andrew Pharmacy Director North Valley Hospital 4068633510	Matulionis, Andrew Director of Pharmacy Logan Health-Whitefish 4068633510	8/25/2022 11:15 AM
Details	Last Recertification Date	Update	Recertification	8/16/2021 2:19:58 PM	8/25/2022 11:15:40 AM	8/25/2022 11:15 AM
Addresses	Billing Address	Update	Change Request	NORTH VALLEY HOSPITAL 1600 HOSPITAL WAY WHITEFISH, MT 59937	Logan Health - Whitefish 1600 HOSPITAL WAY WHITEFISH, MT 59937	9/23/2021 11:22 AM
Addresses	Shipping Address	Update	Change Request	NORTH VALLEY HOSPITAL 1600 HOSPITAL WAY WHITEFISH, MT 59937	Logan Health - Whitefish 1600 HOSPITAL WAY WHITEFISH, MT 59937	9/23/2021 11:22 AM
Details	Entity Subname	Update	Change Request	BEHAVIORAL HEALTH CLINIC - PSYCHIATRY CLINIC	Logan Health Behavioral Health Clinic - Whitefish	9/23/2021 11:22 AM
Details	Entity Name	Update	Change Request	NORTH VALLEY HOSPITAL	Logan Health - Whitefish	9/23/2021 11:22 AM
Details	Last Recertification Date	Update	Recertification	8/19/2020 6:56:31 PM	8/16/2021 2:19:58 PM	8/16/2021 2:19 PM
Details	Last Recertification Date	Update	Recertification	8/23/2019 10:38:27 AM	8/19/2020 6:56:31 PM	8/19/2020 6:56 PM
Details	Last Recertification Date	Update	Recertification		8/23/2019 10:38:27 AM	8/23/2019 10:38 AM
Details	State	Update		Approved	Active	7/1/2019 12:05 AM
Contacts	Signed By	Insert	New Registration		Richhart, David Chief Financial Officer NORTH VALLEY HOSPITAL, INC. 4068639826	4/22/2019 1:45 PM
Details	340B ID	Update	New Registration		CAH271336-05	4/22/2019 1:45 PM
Details	Entity Subname	Update	New Registration	BEHAVIORAL HEALTH CLINIC	BEHAVIORAL HEALTH CLINIC - PSYCHIATRY CLINIC	4/22/2019 1:45 PM
Dates	Participating Approval Date	Update	New Registration		4/22/2019 1:45:38 PM	4/22/2019 1:45 PM
Details	State	Update	New Registration	Pending	Approved	4/22/2019 1:45 PM
Dates	Signed By Date	Update	New Registration		4/21/2019 12:03:05 PM	4/22/2019 1:45 PM
Dates	Start Date	Update	New Registration		7/1/2019 12:00:00 AM	4/22/2019 1:45 PM
Addresses	Main Address	Insert	New Registration		2004 HOSPITAL WAY WHITEFISH, MT 59937	4/9/2019 12:24 PM
Addresses	Billing Address	Insert	New Registration		NORTH VALLEY HOSPITAL 1600 HOSPITAL WAY WHITEFISH, MT 59937	4/9/2019 12:24 PM
Addresses	Shipping Address	Insert	New Registration		NORTH VALLEY HOSPITAL 1600 HOSPITAL WAY WHITEFISH, MT 59937	4/9/2019 12:24 PM
Contacts	Primary Contact	Insert	New Registration		Matulionis, Andrew Pharmacy Director North Valley Hospital 4068633510	4/9/2019 12:24 PM
Contacts	Authorizing Official	Insert	New Registration		Richhart, David Chief Financial Officer NORTH VALLEY HOSPITAL, INC. 4068639826	4/9/2019 12:24 PM
Details	Last Recertification Date	Insert	New Registration			4/9/2019 12:24 PM
Details	Grant Number	Insert	New Registration			4/9/2019 12:24 PM
Details	340B ID	Insert	New Registration			4/9/2019 12:24 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			4/9/2019 12:24 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			4/9/2019 12:24 PM
Details	Medicare Provider Number	Insert	New Registration		271336	4/9/2019 12:24 PM
Details	Entity Name	Insert	New Registration		NORTH VALLEY HOSPITAL	4/9/2019 12:24 PM
Details	Program Code	Insert	New Registration		CAH	4/9/2019 12:24 PM
Details	Entity Subname	Insert	New Registration		BEHAVIORAL HEALTH CLINIC	4/9/2019 12:24 PM
Dates	Participating Approval Date	Insert	New Registration			4/9/2019 12:24 PM
Details	State	Insert	New Registration		Pending	4/9/2019 12:24 PM
Dates	Registration Date	Insert	New Registration		4/9/2019 12:24:11 PM	4/9/2019 12:24 PM
Dates	Signed By Date	Insert	New Registration			4/9/2019 12:24 PM
Dates	Start Date	Insert	New Registration			4/9/2019 12:24 PM
Terminations	Termination Comments	Insert	New Registration			4/9/2019 12:24 PM
Terminations	Termination Date	Insert	New Registration			4/9/2019 12:24 PM
Terminations	Termination Effective Date	Insert	New Registration			4/9/2019 12:24 PM
Terminations	Termination Reason	Insert	New Registration			4/9/2019 12:24 PM