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DSH270049M ST VINCENT HEALTHCARE (Terminated)
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Main Details
Name
ST VINCENT HEALTHCARE
Subdivision Name
WEST GRAND FAMILY MEDICINE
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH270049M
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
2750 GRAND AVE
WEST GRAND FAMILY MEDICINE
BILLINGS, MT 59102-2629
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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