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DSH270049L St. Vincent Healthcare (Terminated)
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Main Details
Name
St. Vincent Healthcare
Subdivision Name
WALK IN CLINIC
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH270049L
Medicare Provider Number
270049
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/16/2017
Participating Start Date
1/1/2018
Participating Approval Date
10/17/2017
Last Recertification Date
8/16/2018
Termination Date
Termination Reason
7/1/2019
Hospital Outpatient facility no longer eligible
Contacts
Authorizing Official
SCL Health
Pam Palagi, VP of Finacial Services
(406) 723-2414
Primary Contact
SCL St. Vincent Healthcare
Lonnye Finneman, Director of Pharmacy
(406) 237-8123
Addresses
Street Address
1027 North 27th Street
WALK IN CLINIC
BILLINGS, MT 59101
Billing Address
SCL Health St. Vincent Healthcare
PO Box 1010
Accounts Payable
Lafayette, CO 80026
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participating from effective date (1/1/2016) until terminated effective date (7/1/2017), reinstatement effective date (01/01/2018)
10/17/2017
April 2025
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