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CAH271320-04 ST. JOHN'S LUTHERAN HOSPITAL DBA CABINET PEAKS MEDICAL CENTER (Active)
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Main Details
Name
ST. JOHN'S LUTHERAN HOSPITAL DBA CABINET PEAKS MEDICAL CENTER
Subdivision Name
CABINET PEAKS MEDICAL CENTER - Cabinet Peaks Clinic-General Surgery
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH271320-04
Medicare Provider Number
271320
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/7/2020
Participating Start Date
1/1/2021
Participating Approval Date
10/19/2020
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
St. John's Lutheran Hospital DBA Cabinet Peaks Medical Center
Gayl Smith, Controller
(406) 283-7139
Primary Contact
Cabinet Peaks Medical Center
Amie Wells, Pharmacy Manager
(406) 283-7189
Addresses
Street Address
308 LOUISIANA AVE
STE 1
LIBBY, MT 59923-2159
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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