340B Drug Pricing Program Database
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CAH271343-00 Providence Saint Joseph Medical Center (Active)
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Main Details
Name
Providence Saint Joseph Medical Center
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH271343-00
Medicare Provider Number
271343
Additional Details
Current Program Status
Active
Registration Date
9/16/2011
Participating Start Date
10/1/2011
Participating Approval Date
9/19/2011
Last Recertification Date
8/15/2024
Contacts
Authorizing Official
Providence St. Patrick Hospital
Kirk Bodlovic, Chief Operating Officer
(406) 327-1740
Primary Contact
Providence St. Joseph Medical Center
Paige Stone, Pharmacy Manager
(406) 883-8451
Addresses
Street Address
6-13th AVENUE EAST
POLSON, MT 59860
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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4/3/12 - Removed NPI# (was 1821184888)
04/03/2012
June 2025
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