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CAH271347-00 Holy Rosary Healthcare dba Intermountain Health Holy Rosary Hospital (Active)
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Main Details
Name
Holy Rosary Healthcare dba Intermountain Health Holy Rosary Hospital
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH271347-00
Medicare Provider Number
271347
Additional Details
Current Program Status
Active
Registration Date
8/19/2011
Participating Start Date
10/1/2011
Participating Approval Date
9/20/2011
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
SCL Health Montana Region
Pam Palagi, VP Financial Services
(406) 723-2414
Primary Contact
Intermountain Health
Ben Landry, 340B Pharmacist
(207) 200-5264
Addresses
Street Address
2600 Wilson Street
Miles City, MT 59301
Billing Address
Intermountain Health Holy Rosary Hospital
P.O. Box 1010
Lafayette, CO 80026
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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12/16/11- Deleted Medicaid#(was 0419666 )and NPI #(was 1396074548)
12/16/2011
April 2025
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