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DSH270049P ST VINCENT HEALTHCARE (Terminated)
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Main Details
Name
ST VINCENT HEALTHCARE
Subdivision Name
ST. VINCENT BILLINGS / Broadwater Clinic
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH270049P
Medicare Provider Number
270049
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/15/2015
Participating Start Date
1/1/2016
Participating Approval Date
10/30/2015
Last Recertification Date
8/18/2016
Termination Date
Termination Reason
7/1/2017
Site closure
Contacts
Authorizing Official
SCL Health
Pam Palagi, VP of Finacial Services
(406) 723-2414
Primary Contact
SCL Health
Lonnye Finneman, Director of Pharmacy
(406) 237-8100
Addresses
Street Address
2019 BROADWATER AVE
SVPN BROADWATER CLINIC
BILLINGS, MT 59102-4810
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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