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IHC HEALTH SERVICES, INC.
DSH270049 Intermountain Health St Vincent Regional Hospital
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Covered Entity Details
Entity Name
Intermountain Health St Vincent Regional Hospital
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH270049
Entity Address
1233 N. 30th Street
Billings, MT 59101
Medicare Provider Number
270049
Participating Start Date
10/1/2012
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
IHC HEALTH SERVICES, INC.
Pharmacy Address
DBA: INTERMOUNTAIN HOME DELIVERY PHARMAC
DBA: INTERMOUNTAIN SPECIALTY PHARMACY
7268 S BINGHAM JUNCTION BLVD STE B1
MIDVALE, UT 84047
Pharmacy Comments
Contract Details
Approval Date
10/19/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Pam Palagi, VP Financial Services
(406) 723-2414
Contract Pharmacy Representative
Intermountain Healthcare
Carrie Dunford, Chief Pharmacy Officer
(801) 284-1004
Signed By Date
10/19/2023
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