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DSH270012AQ BENEFIS HOSPITALS INC. (Terminated)
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Main Details
Name
BENEFIS HOSPITALS INC.
Subdivision Name
BENEFIS HOSPITALS, INC. - Northwest Clinic
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH270012AQ
Medicare Provider Number
270012
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/14/2021
Participating Start Date
7/1/2021
Participating Approval Date
4/28/2021
Last Recertification Date
8/24/2022
Termination Date
Termination Reason
7/1/2023
Hospital Outpatient facility no longer eligible
Contacts
Authorizing Official
Benefis Hospitals Inc.
Forrest Ehlinger, Chief Financial Officer
(406) 455-5479
Primary Contact
Benefis Hospitals Inc
JAMIE Hinzman LEONARD, Pharmacy Director
(406) 455-5434
Addresses
Street Address
25 14TH AVE NW
GREAT FALLS, MT 59404-1954
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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