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CAH271336-03 NORTH VALLEY HOSPITAL (Terminated)
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Main Details
Name
NORTH VALLEY HOSPITAL
Subdivision Name
NORTH VALLEY HOSPITAL INC - EUREKA HEALTHCARE PRIMARY CARE
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH271336-03
Medicare Provider Number
271336
Outpatient Facility Provider Number
273423
Additional Details
Current Program Status
Terminated
Registration Date
10/16/2017
Participating Start Date
1/1/2018
Participating Approval Date
10/31/2017
Last Recertification Date
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, Inc.
Harley Brotherton, Director of Pharmacy
(406) 863-3530
Addresses
Street Address
298 OSLASKI RD
EUREKA, MT 59917-9052
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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