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MONTANA CVS PHARMACY, L.L.C.
DSH270004 BILLINGS CLINIC
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Covered Entity Details
Entity Name
BILLINGS CLINIC
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH270004
Entity Address
2800 TENTH AVENUE NORTH
BILLINGS, MT 59101
Medicare Provider Number
270004
Participating Start Date
1/1/2016
Last Recertification Date
8/20/2024
Pharmacy Details
Pharmacy Name
MONTANA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 08944
617 CENTRAL ST.
BILLINGS, MT 59102
Pharmacy Comments
Contract Details
Approval Date
12/1/2015
Contract Begin Date
1/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/17/2025
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Lu Byrd, Vice President/Hospital Operations
(406) 238-2328
Contract Pharmacy Representative
Scott Tierney, Senior Director, Payer Relations
(401) 770-2762
Signed By Date
12/1/2015
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