340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
RRC130049-53 KOOTENAI HEALTH INC (Approved)
Print
Main Details
Name
KOOTENAI HEALTH INC
Subdivision Name
KOOTENAI CLINIC FAMILY MEDICINE CDA IRONWOOD - FAMILY MEDICINE
Type
Rural Referral Center
Rural
No
340B ID
RRC130049-53
Medicare Provider Number
130049
Outpatient Facility Provider Number
Additional Details
Current Program Status
Approved
Registration Date
4/11/2025
Participating Start Date
7/1/2025
Participating Approval Date
4/29/2025
Last Recertification Date
Contacts
Authorizing Official
Kootenai Health
Michele Bouit, CFO
(208) 625-4004
Primary Contact
Kootenai Health
Jim McDonald, Pharmacy - 340B Program Manager
(208) 625-5653
Addresses
Street Address
914 W Ironwood Drive
Suite 101
Coeur D Alene, ID 83814
Billing Address
Kootenai Health
2003 Kootenai Health Way
Coeur D Alene, ID 83814
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
No records to display.
May 2025
May 2025
week
S
M
T
W
T
F
S
18
27
28
29
30
1
2
3
19
4
5
6
7
8
9
10
20
11
12
13
14
15
16
17
21
18
19
20
21
22
23
24
22
25
26
27
28
29
30
31
23
1
2
3
4
5
6
7
NoFilter
Contains
DoesNotContain
StartsWith
EndsWith
EqualTo
NotEqualTo
GreaterThan
LessThan
GreaterThanOrEqualTo
LessThanOrEqualTo
Between
NotBetween
IsEmpty
NotIsEmpty
IsNull
NotIsNull
Custom
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session