340B Drug Pricing Program Database
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DSH270049U Intermountain Health St Vincent Regional Hospital (Active)
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Main Details
Name
Intermountain Health St Vincent Regional Hospital
Subdivision Name
Rheumatology - Rheumatology Clinic
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH270049U
Medicare Provider Number
270049
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/17/2019
Participating Start Date
7/1/2019
Participating Approval Date
4/23/2019
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
SCL Health Montana Region
Pam Palagi, VP Financial Services
(406) 723-2414
Primary Contact
Intermountain Health
Ben Landry, 340B Pharmacist
(207) 200-5264
Addresses
Street Address
2900 12th Ave N, Ste 503E
503E
Billings, MT 59101
Billing Address
Intermountain Health St Vincent Regional Hospital
Attn: Accounts Payable
P.O. Box 1010
Lafayette, CO 80026
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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