340B Drug Pricing Program Database
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DSH270049Z Intermountain Health St Vincent Regional Hospital (Active)
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Main Details
Name
Intermountain Health St Vincent Regional Hospital
Subdivision Name
GASTRO INTESTINAL SERVICES
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH270049Z
Medicare Provider Number
270049
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/11/2023
Participating Start Date
1/30/2023
Participating Approval Date
1/25/2023
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
1144 N 28TH ST
STE B
BILLINGS, MT 59101-0110
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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