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DSH270032 NORTHERN MONTANA HOSPITAL (Terminated)
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Main Details
Name
NORTHERN MONTANA HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH270032
Medicare Provider Number
270032
Additional Details
Current Program Status
Terminated
Registration Date
9/2/2009
Participating Start Date
10/1/2009
Participating Approval Date
9/4/2009
Last Recertification Date
9/5/2023
Termination Date
Termination Reason
1/1/2024
Other
Contacts
Authorizing Official
Northern Montana Hospital
Christen Obresley, VP, Regulatory Community Services
(406) 262-1420
Primary Contact
Northern Montana Hospital
Claridale Paunel Flynn, Director of Pharmacy
(406) 262-1250
Addresses
Street Address
30-13TH STREET
HAVRE, MT 59501
Billing Address
NORTHERN MONTANA HOSPITAL
PO BOX 1231
HAVRE, MT 59501
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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