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DSH270051AD KALISPELL REGIONAL MEDICAL CENTER d/b/a LOGAN HEALTH MEDICAL CENTER (Active)
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Main Details
Name
KALISPELL REGIONAL MEDICAL CENTER d/b/a LOGAN HEALTH MEDICAL CENTER
Subdivision Name
Logan Health Maternal-Fetal Medicine
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH270051AD
Medicare Provider Number
270051
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/4/2021
Participating Start Date
1/1/2022
Participating Approval Date
10/14/2021
Last Recertification Date
8/14/2024
Contacts
Authorizing Official
Logan Health-Whitefish
Kevin Abel, President
(406) 863-3500
Primary Contact
Logan Health
Landon Dean Godfrey, Director of Pharmacy
(406) 756-4701
Addresses
Street Address
210 Sunnyview Lane
Suite 103
Kalispell, MT 59901
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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