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CAH271336-02 NORTH VALLEY HOSPITAL (Terminated)
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Main Details
Name
NORTH VALLEY HOSPITAL
Subdivision Name
NORTH VALLEY PROFESSIONAL CENTER
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH271336-02
Medicare Provider Number
271336
Outpatient Facility Provider Number
273424
Additional Details
Current Program Status
Terminated
Registration Date
7/11/2014
Participating Start Date
10/1/2014
Participating Approval Date
8/12/2014
Last Recertification Date
11/28/2017
Termination Date
Termination Reason
4/1/2018
Business decision by the Covered Entity
Contacts
Authorizing Official
NORTH VALLEY HOSPITAL, INC.
David Richhart, Chief Financial Officer
(406) 863-9826
Primary Contact
North Valley Hospital
Harley Brotherton, Director of Pharmacy
(406) 863-3530
Addresses
Street Address
2165 9TH STREET WEST
COLUMBIA FALLS, MT 59912
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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