340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
INTERMOUNTAIN HEALTH GOOD SAMARITAN HOSP
DSH270049 Intermountain Health St Vincent Regional Hospital
Print
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
INTERMOUNTAIN HEALTH GOOD SAMARITAN HOSP
Pharmacy Address
PHARMACY DEPT
200 EXEMPLA CIR
LAFAYETTE, CO 80026
Pharmacy Comments
Contract Details
Approval Date
10/12/2015
Contract Begin Date
1/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/21/2020
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Ron Oldfield, CFO
(406) 237-3314
Contract Pharmacy Representative
Doug Malcolm, Pharmacy Manager
(303) 689-4996
Signed By Date
10/12/2015
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