340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
CREDENA HEALTH PHARMACY SACRED HEART
DSH270014 ST PATRICK HOSPITAL
Print
Covered Entity Details
Entity Name
ST PATRICK HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH270014
Entity Address
500 W. BROADWAY ST
MISSOULA, MT 59802
Medicare Provider Number
270014
Participating Start Date
10/1/2022
Last Recertification Date
8/15/2024
Pharmacy Details
Pharmacy Name
CREDENA HEALTH PHARMACY SACRED HEART
Pharmacy Address
101 W 8TH AVE STE 207653
SPOKANE, WA 99204-2307
Pharmacy Comments
Contract Details
Approval Date
8/5/2022
Contract Begin Date
10/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kirk Bodlovic, Chief Operating Officer
(406) 327-1740
Contract Pharmacy Representative
Credena Health LLC
Tammy pierce, Director of Pharmacy
(503) 215-6557
Signed By Date
7/11/2022
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