340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
CREDENA HEALTH PHARMACY ST JOSEPH
CAH271343-00 Providence Saint Joseph Medical Center
Print
Covered Entity Details
Entity Name
Providence Saint Joseph Medical Center
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH271343-00
Entity Address
6-13th AVENUE EAST
POLSON, MT 59860
Medicare Provider Number
271343
Participating Start Date
10/1/2011
Last Recertification Date
8/15/2024
Pharmacy Details
Pharmacy Name
CREDENA HEALTH PHARMACY ST JOSEPH
Pharmacy Address
6 13TH AVE E
POLSON, MT 59860-5315
Pharmacy Comments
Contract Details
Approval Date
10/14/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Landon Godfrey, Senior Director of Hospital Operations
(406) 883-7486
Contract Pharmacy Representative
Providence
Tammy Pierce, Director of Pharmacy
(503) 962-1700
Signed By Date
10/14/2019
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session