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DSH270014 ST PATRICK HOSPITAL (Active)
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Main Details
Name
ST PATRICK HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH270014
Medicare Provider Number
270014
Additional Details
Current Program Status
Active
Registration Date
7/5/2022
Participating Start Date
10/1/2022
Participating Approval Date
8/5/2022
Last Recertification Date
8/15/2024
Contacts
Authorizing Official
Providence St. Patrick Hospital
Kirk Bodlovic, Chief Operating Officer
(406) 327-1740
Primary Contact
Providence Health & Services - Montana
Kevin Warren Cady, Director of Pharmacy
(406) 329-5720
Addresses
Street Address
500 W. BROADWAY ST
MISSOULA, MT 59802
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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