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SCH270051-55 KALISPELL REGIONAL MEDICAL CENTER (Terminated)
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Main Details
Name
KALISPELL REGIONAL MEDICAL CENTER
Subdivision Name
Pediatric Neurosurgery - Montana Children's Specialists - Pediatric Neurosurgery
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH270051-55
Medicare Provider Number
270051
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/1/2020
Participating Start Date
10/1/2020
Participating Approval Date
8/27/2020
Last Recertification Date
Termination Date
Termination Reason
1/1/2021
Change of covered entity type
Contacts
Authorizing Official
Kalispell Regional Healthcare
Craig O Boyer, Chief Financial Officer
(406) 752-5111
Primary Contact
Kalispell Regional Medical Center
Tera Thorderson, Pharmacist
(406) 607-8004
Addresses
Street Address
202 Conway Drive
Kalispell, MT 59901
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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