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CAH271320-01 ST. JOHN'S LUTHERAN HOSPITAL DBA CABINET PEAKS MEDICAL CENTER (Active)
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Main Details
Name
ST. JOHN'S LUTHERAN HOSPITAL DBA CABINET PEAKS MEDICAL CENTER
Subdivision Name
OBSERVATION/EMERGENCY ROOM/AMBULATORY SURGERY
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH271320-01
Medicare Provider Number
271320
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
3/3/2011
Participating Start Date
4/1/2011
Participating Approval Date
3/9/2011
Last Recertification Date
8/20/2024
Contacts
Authorizing Official
St. John's Lutheran Hospital DBA Cabinet Peaks Medical Center
Gayl Smith, Controller
(406) 283-7139
Primary Contact
Cabinet Peaks Medical Center
Amie Wells, Pharmacy Manager
(406) 283-7189
Addresses
Street Address
209 Health Park Drive
LIBBY, MT 59923
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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9/21/11-Removed NPI # (was 1952312050)
09/21/2011
May 2025
May 2025
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