340B Drug Pricing Program Database
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DSH270049X Intermountain Health St Vincent Regional Hospital (Active)
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Main Details
Name
Intermountain Health St Vincent Regional Hospital
Subdivision Name
ST VINCENT REGIONAL HOSPITAL CANCER CENTERS OF MONTANA - Radiation Therapy
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH270049X
Medicare Provider Number
270049
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/13/2021
Participating Start Date
1/1/2022
Participating Approval Date
11/22/2021
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
SCL Health Montana Region
Pam Palagi, VP Financial Services
(406) 723-2414
Primary Contact
Intermountain Health
Ben Landry, 340B Pharmacist
(207) 200-5264
Addresses
Street Address
1315 Golden Valley Circle
Billings, MT 59102
Billing Address
Intermountain Health St Vincent Regional Hospital
Attn: Accounts Payable
P.O. Box 1010
Lafayette, CO 80026
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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