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DSH270051S KALISPELL REGIONAL MEDICAL CENTER d/b/a LOGAN HEALTH MEDICAL CENTER (Terminated)
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Main Details
Name
KALISPELL REGIONAL MEDICAL CENTER d/b/a LOGAN HEALTH MEDICAL CENTER
Subdivision Name
Logan Health Neuroscience & Spine
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH270051S
Medicare Provider Number
270051
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/7/2020
Participating Start Date
1/1/2021
Participating Approval Date
11/23/2020
Last Recertification Date
9/10/2021
Termination Date
Termination Reason
1/1/2022
Other
Contacts
Authorizing Official
DSH270051
CRAIG O BOYER, Chief Financial Officer
(406) 751-5368
Primary Contact
Kalispell Regional Medical Center
Tera Thorderson, Pharmacist
(406) 607-8004
Addresses
Street Address
200 COMMONS WAY
KALISPELL, MT 59901-1915
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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