Covered Entity Details

DSH060024BN UNIVERSITY OF COLORADO HOSPITAL (Active) - information as of 4/28/2025 1:48:42 AM

Main Details

Name

UNIVERSITY OF COLORADO HOSPITAL

Subdivision Name

AMC PULM REHAB OP - Pulmonary Rehab

Type

Disproportionate Share Hospital

Rural

Yes

340B ID

DSH060024BN

Medicare Provider Number

060024

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

10/14/2024

Participating Start Date

1/1/2025

Participating Approval Date

11/13/2024

Last Recertification Date

Contacts

Authorizing Official

UCHealth
Julie Nickell, Chief Financial Officer - Metro
(720) 848-7773

Primary Contact

University of Colorado Hospital
Adam Matthew Poust, Manager, Pharmacy Hospital Operations
(720) 848-3243

Addresses

Street Address

12401 E. 17th Avenue
Aurora, CO 80045

Billing Address

UCHealth Accounts Payable
2400 S. Peoria Street
Suite 211
Aurora, CO 80014

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
Yes

State	Medicaid Number	NPI Number
CO	05024005	1477531580

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
DSH060024A	Child	DSH	UNIVERSITY OF COLORADO HOSPITAL	CANCER CENTER INFUSION	1665 AURORA CT.,	AURORA	CO	Active
DSH060024AA	Child	DSH	UNIVERSITY OF COLORADO HOSPITAL	Magnetic Resonance Radiology Lone Tree	9548 Park Meadows Drive	Lone Tree	CO	Active
DSH060024AB	Child	DSH	UNIVERSITY OF COLORADO HOSPITAL	CT Scan Radiology Lone Tree	9548 Park Meadows Drive	Lone Tree	CO	Active
DSH060024AC	Child	DSH	UNIVERSITY OF COLORADO HOSPITAL	Radiology Diagnostic Pet/CT Lone Tree	9548 Park Meadows Drive	Lone Tree	CO	Active
DSH060024AD	Child	DSH	UNIVERSITY OF COLORADO HOSPITAL	Radiology Diagnostic Lone Tree	9548 Park Meadows Drive	Lone Tree	CO	Active
DSH060024AE	Child	DSH	UNIVERSITY OF COLORADO HOSPITAL	Rad-Colorado Center-MRI	2000 S. Colorado Boulevard	Denver	CO	Active
DSH060024AF	Child	DSH	UNIVERSITY OF COLORADO HOSPITAL	Breast Center - Lone Tree	9544, Park Meadows Drive	Lone Tree	CO	Active
DSH060024AG	Child	DSH	UNIVERSITY OF COLORADO HOSPITAL	UCH Eye Center at Cherry Creek	2000 S. COLORADO BLVD	DENVER	CO	Active
DSH060024AH	Child	DSH	UNIVERSITY OF COLORADO HOSPITAL	Cedar Outpatient Care	1693 North Quentin Street	Aurora	CO	Active
DSH060024AJ	Child	DSH	UNIVERSITY OF COLORADO HOSPITAL	UCHealth Eye Center - Boulder	5495 ARAPAHOE AVE	BOULDER	CO	Active
DSH060024AK	Child	DSH	UNIVERSITY OF COLORADO HOSPITAL	Boulder Health Center - Specialty Practices Boulder	5495 Arapahoe Avenue	Boulder	CO	Active
DSH060024AL	Child	DSH	UNIVERSITY OF COLORADO HOSPITAL	CEDAR Outpatient Care - CeDAR Boulder BH Outpatient	5495 Arapahoe Avenue	Boulder	CO	Terminated
DSH060024AM	Child	DSH	UNIVERSITY OF COLORADO HOSPITAL	Littleton Cancer Center - Medical Oncology	5 West Dry Creek Circle	Littleton	CO	Terminated
DSH060024AN	Child	DSH	UNIVERSITY OF COLORADO HOSPITAL	Littleton Cancer Center - LTL Infusion	1500 Park Central Dr. #G034	Highlands Ranch	CO	Active
DSH060024AP	Child	DSH	UNIVERSITY OF COLORADO HOSPITAL	UNIVERSITY OF COLORADO HOSPITAL AUT - Neurology clinic	1635 AURORA CT	AURORA	CO	Terminated
DSH060024AQ	Child	DSH	UNIVERSITY OF COLORADO HOSPITAL	UCHEALTH EMERGENCY ROOM - SMOKY HIL - Aurtlyn ED	25551 E SMOKY HILL RD	AURORA	CO	Terminated
DSH060024AR	Child	DSH	UNIVERSITY OF COLORADO HOSPITAL	Free Standing Emergency Room Departments - Commerce ED	15100 E. 104th Ave	Commerce City	CO	Active
DSH060024AS	Child	DSH	UNIVERSITY OF COLORADO HOSPITAL	UCHEALTH LITTLETON RAD ONC - LTL Radiation Therapy	1500 Park Central Dr.	Highlands Ranch	CO	Active
DSH060024AT	Child	DSH	UNIVERSITY OF COLORADO HOSPITAL	UCHealth Foot and Ankle Clinic - Foot and Ankle Clinic	3055 Roslyn St.	Denver	CO	Active
DSH060024AU	Child	DSH	UNIVERSITY OF COLORADO HOSPITAL	Free Standing Emergency Departments - Thorn120 ED	12020 Colorado Blvd	Thornton	CO	Active
DSH060024AV	Child	DSH	UNIVERSITY OF COLORADO HOSPITAL	Free Standing Emergency Departments - Aurmiss ED	15300 E. Mississippi Ave.	Aurora	CO	Active
DSH060024AW	Child	DSH	UNIVERSITY OF COLORADO HOSPITAL	UCHEALTH EMERGENCY ROOM - ARVADA - Arvada ED	9505 RALSTON RD	ARVADA	CO	Active
DSH060024AX	Child	DSH	UNIVERSITY OF COLORADO HOSPITAL	Free Standing Emergency Departments - Parker ED	16990 Village Center drive East	Parker	CO	Terminated
DSH060024AY	Child	DSH	UNIVERSITY OF COLORADO HOSPITAL	UCHEALTH EMERGENCY ROOM - GREEN VAL - Greenval ED	18610 GREEN VALLEY RANCH BLVD	DENVER	CO	Active
DSH060024AZ	Child	DSH	UNIVERSITY OF COLORADO HOSPITAL	Free Standing Emergency Departments - Littletn ED	13351 West Bowles Ave.	Littleton	CO	Terminated
DSH060024BA	Child	DSH	UNIVERSITY OF COLORADO HOSPITAL	UCHEALTH OUTPATIENT PSYCH CLINIC - Psychiatry	13001 E 17TH PL	AURORA	CO	Terminated
DSH060024BB	Child	DSH	UNIVERSITY OF COLORADO HOSPITAL	UCHEALTH INTEGRATED MEDICINE CENTER - Integrated medicine	3055 ROSLYN ST	DENVER	CO	Terminated
DSH060024BC	Child	DSH	UNIVERSITY OF COLORADO HOSPITAL	LEPRINO NEUROSURGERY - Stroke and Brain aneurysm center	12401 E 17th Ave	Aurora	CO	Active
DSH060024BD	Child	DSH	UNIVERSITY OF COLORADO HOSPITAL	UCHEALTH SLEEP MEDICINE CLINIC - Sleep lab	3055 ROSLYN ST	DENVER	CO	Active
DSH060024BF	Child	DSH	UNIVERSITY OF COLORADO HOSPITAL	UCHEALTH OUTPATIENT PSYCH CLINIC - Psychiatry Community	13001 E 17TH PL	AURORA	CO	Terminated
DSH060024BG	Child	DSH	UNIVERSITY OF COLORADO HOSPITAL	UCHEALTH - NEUROLOGY CLINIC - Neurology Stapleton	3055 ROSLYN ST	DENVER	CO	Active
DSH060024BH	Child	DSH	UNIVERSITY OF COLORADO HOSPITAL	UCHEALTH CCMC INFUSION OUTPATIENT - Chemotherapy	100 COOK ST	DENVER	CO	Active
DSH060024BJ	Child	DSH	UNIVERSITY OF COLORADO HOSPITAL	UCHEALTH CU SPORTS MEDICINE CO CTR - Radiology Sports Med	2000 S COLORADO BLVD	DENVER	CO	Active
DSH060024BK	Child	DSH	UNIVERSITY OF COLORADO HOSPITAL	UCHEALTH CCMC RADIATION ONCOLOGY OP - UCH Radiation Oncology at CCMC	100 COOK ST	DENVER	CO	Active
DSH060024BL	Child	DSH	UNIVERSITY OF COLORADO HOSPITAL	UCHealth Radiology Diagnostic - Central Park - Radiology Diagnostic	3055 Roslyn Street	Denver	CO	Active
DSH060024BM	Child	DSH	UNIVERSITY OF COLORADO HOSPITAL	LEPRINO NEUROLOGY CLINIC - Neurology	12401 E. 17th Avenue	Aurora	CO	Active
DSH060024BN	Child	DSH	UNIVERSITY OF COLORADO HOSPITAL	AMC PULM REHAB OP - Pulmonary Rehab	12401 E. 17th Avenue	Aurora	CO	Active
DSH060024BP	Child	DSH	UNIVERSITY OF COLORADO HOSPITAL	AMC CLB Sleep OP - Sleep Lab - AMC CLB Sleep OP - Leprino	12401 E. 17th Avenue	Aurora	CO	Active
DSH060024BQ	Child	DSH	UNIVERSITY OF COLORADO HOSPITAL	HRMC PHARMACOTHERAPY - Pharmacotherapy	1500 Park Central Drive	Highlands Ranch	CO	Approved
DSH060024E	Child	DSH	UNIVERSITY OF COLORADO HOSPITAL	UNIVERSITY LOWRY CLINIC	8111 E. LOWRY BLVD	DENVER	CO	Active
DSH060024F	Child	DSH	UNIVERSITY OF COLORADO HOSPITAL	OUTPATIENT INFUSION CENTER	1635 AURORA CT.	AURORA	CO	Active
DSH060024G	Child	DSH	UNIVERSITY OF COLORADO HOSPITAL	UCH EYE CENTER ANSCHUTZ	1675 AURORA CT.	AURORA	CO	Active
DSH060024L	Child	DSH	UNIVERSITY OF COLORADO HOSPITAL	UMGP - BOULDER	5495 Arapahoe Avenue	BOULDER	CO	Active
DSH060024N	Child	DSH	UNIVERSITY OF COLORADO HOSPITAL	UM - AF WILLIAMS	3055 ROSLYN STREET	DENVER	CO	Active
DSH060024O	Child	DSH	UNIVERSITY OF COLORADO HOSPITAL	PARK MEADOWS	9540 Park Meadows Drive	LONETREE	CO	Terminated
DSH060024P	Child	DSH	UNIVERSITY OF COLORADO HOSPITAL	UM - WESTMINSTER	7403 CHURCH RANCH BLVD	WESTMINSTER	CO	Active
DSH060024Q	Child	DSH	UNIVERSITY OF COLORADO HOSPITAL	Sports Medicine	2000 S. Colorado Boulevard	Denver	CO	Active
DSH060024S	Child	DSH	UNIVERSITY OF COLORADO HOSPITAL	TomoTherapy Cancer Treatment Center	10463 Park Meadows Drive	Lone Tree	CO	Terminated
DSH060024T	Child	DSH	UNIVERSITY OF COLORADO HOSPITAL	UCH Eye Center LoDo	1435 Wazee St.	Denver	CO	Active
DSH060024U	Child	DSH	UNIVERSITY OF COLORADO HOSPITAL	UCH Eye Center Park Meadows	9552 Park Meadows Dr	Lone Tree	CO	Active
DSH060024V	Child	DSH	UNIVERSITY OF COLORADO HOSPITAL	LONETREE PRIMCARE, FAM/INT	9540 Park Meadows Drive	Lone Tree	CO	Active
DSH060024W	Child	DSH	UNIVERSITY OF COLORADO HOSPITAL	ASC - Lone Tree Amb Surgery Center	9218 Kimmer Drive	Lone Tree	CO	Terminated
DSH060024X	Child	DSH	UNIVERSITY OF COLORADO HOSPITAL	Lone Tree - Lone Tree Health Center	9548 Park Meadows Drive	Lone Tree	CO	Active
DSH060024Y	Child	DSH	UNIVERSITY OF COLORADO HOSPITAL	UM Denver Lowry Specialty Practice	8111 E. Lowry Boulevard	Denver	CO	Active
DSH060024Z	Child	DSH	UNIVERSITY OF COLORADO HOSPITAL	General Surgery Aesthetic Plastic Surgery Park Meadows	9544 Park Meadows Drive	Lone Tree	CO	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Contacts	Primary Contact	Update	Change Request	Best, Mary Director of Pharmacy UCHealth 7208484197	Poust, Adam Matthew Manager, Pharmacy Hospital Operations University of Colorado Hospital 7208483243	1/6/2025 10:52 AM
Details	State	Update		Approved	Active	1/1/2025 12:01 AM
Contacts	Signed By	Insert	New Registration		Nickell, Julie Chief Financial Officer - Metro UCHealth 7208487773	11/13/2024 11:31 AM
Details	340B ID	Update	New Registration		DSH060024BN	11/13/2024 11:31 AM
Details	Entity Subname	Update	New Registration	AMC PULM REHAB OP	AMC PULM REHAB OP - Pulmonary Rehab	11/13/2024 11:31 AM
Dates	Participating Approval Date	Update	New Registration		11/13/2024 11:31:46 AM	11/13/2024 11:31 AM
Details	State	Update	New Registration	Pending	Approved	11/13/2024 11:31 AM
Dates	Signed By Date	Update	New Registration		11/7/2024 1:01:17 PM	11/13/2024 11:31 AM
Dates	Start Date	Update	New Registration		1/1/2025 12:00:00 AM	11/13/2024 11:31 AM
Contacts	Primary Contact	Update	Profile Change Request	Best, Mary Director of Pharmacy Operations UCHealth 7208484197	Best, Mary Director of Pharmacy UCHealth 7208484197	10/17/2024 2:19 PM
Addresses	Main Address	Insert	New Registration		12401 E. 17th Avenue Aurora, CO 80045	10/14/2024 5:50 PM
Addresses	Billing Address	Insert	New Registration		UCHealth Accounts Payable 2400 S. Peoria Street Suite 211 Aurora, CO 80014	10/14/2024 5:50 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	10/14/2024 5:50 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		05024005	10/14/2024 5:50 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		CO	10/14/2024 5:50 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1477531580	10/14/2024 5:50 PM
Medicaid Billing	NPI: State	Insert	New Registration		CO	10/14/2024 5:50 PM
Contacts	Primary Contact	Insert	New Registration		Best, Mary Director of Pharmacy Operations UCHealth 7208484197	10/14/2024 5:50 PM
Contacts	Authorizing Official	Insert	New Registration		Nickell, Julie Chief Financial Officer - Metro UCHealth 7208487773	10/14/2024 5:50 PM
Details	Assistance Received From Date	Insert	New Registration			10/14/2024 5:50 PM
Details	Assistance Received To Date	Insert	New Registration			10/14/2024 5:50 PM
Details	Last Recertification Date	Insert	New Registration			10/14/2024 5:50 PM
Details	Grant Number	Insert	New Registration			10/14/2024 5:50 PM
Details	340B ID	Insert	New Registration			10/14/2024 5:50 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			10/14/2024 5:50 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			10/14/2024 5:50 PM
Details	Medicare Provider Number	Insert	New Registration		060024	10/14/2024 5:50 PM
Details	Entity Name	Insert	New Registration		UNIVERSITY OF COLORADO HOSPITAL	10/14/2024 5:50 PM
Details	NOFO Number	Insert	New Registration			10/14/2024 5:50 PM
Details	Program Code	Insert	New Registration		DSH	10/14/2024 5:50 PM
Details	Entity Subname	Insert	New Registration		AMC PULM REHAB OP	10/14/2024 5:50 PM
Dates	Participating Approval Date	Insert	New Registration			10/14/2024 5:50 PM
Details	State	Insert	New Registration		Pending	10/14/2024 5:50 PM
Dates	Registration Date	Insert	New Registration		10/14/2024 5:50:45 PM	10/14/2024 5:50 PM
Dates	Signed By Date	Insert	New Registration			10/14/2024 5:50 PM
Dates	Start Date	Insert	New Registration			10/14/2024 5:50 PM
Terminations	Termination Comments	Insert	New Registration			10/14/2024 5:50 PM
Terminations	Termination Date	Insert	New Registration			10/14/2024 5:50 PM
Terminations	Termination Effective Date	Insert	New Registration			10/14/2024 5:50 PM
Terminations	Termination Reason	Insert	New Registration			10/14/2024 5:50 PM