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CAH131328-00 Bonner General Hospital (Active)
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Main Details
Name
Bonner General Hospital
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH131328-00
Medicare Provider Number
131328
Additional Details
Current Program Status
Active
Registration Date
1/15/2014
Participating Start Date
4/1/2014
Participating Approval Date
3/5/2014
Last Recertification Date
8/12/2024
Contacts
Authorizing Official
Bonner General Health
John Hennessy, CEO
(208) 265-1100
Primary Contact
Bonner General Hospital
Sandra Lee Brower, Certified Pharmacy Technician/ Primary Contact
(208) 265-3731 Ext: 1095
Addresses
Street Address
520 North 3rd Avenue
Sandpoint, ID 83864
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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