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DSH270049A Intermountain Health St Vincent Regional Hospital (Active)
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Main Details
Name
Intermountain Health St Vincent Regional Hospital
Subdivision Name
Neurosciences-Multiple Sclerosis Center
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH270049A
Medicare Provider Number
270049
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
5/25/2018
Participating Start Date
7/1/2018
Participating Approval Date
6/4/2018
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
1041 N. 29th St
Billings, MT 59101
Billing Address
Intermountain Health St Vincent Regional Hospital
PO Box 1010
Lafayette, CO 80026
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 4/1/2013; Terminated 7/1/2017; Reinstated 7/1/2018.
06/01/2018
April 2025
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