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CAH271343-01 Providence Saint Joseph Medical Center (Active)
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Main Details
Name
Providence Saint Joseph Medical Center
Subdivision Name
PROVIDENCE ST JOSEPH MEDICAL CENTER
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH271343-01
Medicare Provider Number
271343
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/14/2016
Participating Start Date
1/1/2017
Participating Approval Date
10/31/2016
Last Recertification Date
8/14/2024
Contacts
Authorizing Official
Providence St. Patrick Hospital
Kirk Bodlovic, Chief Operating Officer
(406) 327-1740
Primary Contact
Providence St. Joseph Medical Center
Paige Stone, Pharmacy Manager
(406) 883-8451
Addresses
Street Address
63351 US HIGHWAY 93
PROV ST JOSEPH MED CTR
RONAN, MT 59864-2702
Billing Address
PROV ST JOSEPH MED CTR
6-13th Avenue East
Polson, MT 59860
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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