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SCH270051-04 KALISPELL REGIONAL MEDICAL CENTER (Terminated)
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Main Details
Name
KALISPELL REGIONAL MEDICAL CENTER
Subdivision Name
THE BASS BREAST CENTER
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH270051-04
Medicare Provider Number
270051
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
9/23/2010
Participating Start Date
9/24/2010
Participating Approval Date
9/24/2010
Last Recertification Date
8/16/2018
Termination Date
Termination Reason
9/13/2018
Hospital Outpatient facility no longer eligible
Contacts
Authorizing Official
Kalispell Regional Healthcare
Craig O Boyer, Chief Financial Officer
(406) 752-5111
Primary Contact
Kalispell Regional
Dennice J Taylor, Accountant II, 340b Analyst
(406) 751-6560
Addresses
Street Address
310 SUNNYVIEW LANE
KALISPELL, MT 59901
Billing Address
KALISPELL REGIONAL MEDICAL CENTER
202 CONWAY DRIVE, SUITE 100
KALISPELL, MT 59901
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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