| Details | Last Recertification Date | Update | Recertification | 8/21/2023 1:51:42 PM | 8/23/2024 2:22:43 PM | 8/23/2024 2:22 PM |
| Details | Last Recertification Date | Update | Recertification | 9/2/2022 7:00:12 AM | 8/21/2023 1:51:42 PM | 8/21/2023 1:51 PM |
| Contacts | Primary Contact | Update | Recertification | Jones, Konni
340B Coordinator
Community Hospital
9706443550 | Houchin, Cynthia M
Coordinator
Colorado West Healthcare System
9706443552 | 9/2/2022 7:00 AM |
| Details | Last Recertification Date | Update | Recertification | 8/17/2021 1:36:19 PM | 9/2/2022 7:00:12 AM | 9/2/2022 7:00 AM |
| Details | Last Recertification Date | Update | Recertification | | 8/17/2021 1:36:19 PM | 8/17/2021 1:36 PM |
| Details | State | Update | | Approved | Active | 4/1/2021 12:01 AM |
| Contacts | Primary Contact | Update | Change Request | Houchin, Cynthia
340B Coordinator
Community Hospital
9706443552 | Jones, Konni
340B Coordinator
Community Hospital
9706443550 | 3/16/2021 1:08 PM |
| Addresses | Shipping Address | Delete | Reinstatement | Coloardo West Healthcare System dba Canyon View Pharmacy
2373 G Road
STE 120
Grand Junction, CO 81505-9641 | | 1/21/2021 1:53 PM |
| Addresses | Shipping Address | Insert | Reinstatement | | Colorado West Healthcare System dba Canyon View Pharmacy
2373 G Road
STE 120
Grand Junction, CO 81505-9641 | 1/21/2021 1:53 PM |
| Medicaid Billing | NPI: State | Update | Reinstatement | | CO | 1/21/2021 1:53 PM |
| Details | Last Recertification Date | Update | Reinstatement | 8/28/2019 7:22:33 AM | | 1/21/2021 1:53 PM |
| Dates | Last Date That 340B Drugs Purchased | Update | Reinstatement | 8/31/2020 12:00:00 AM | | 1/21/2021 1:53 PM |
| Dates | Participating Approval Date | Update | Reinstatement | 11/26/2018 7:44:20 AM | 1/21/2021 1:53:08 PM | 1/21/2021 1:53 PM |
| Details | State | Update | Reinstatement | Terminated | Approved | 1/21/2021 1:53 PM |
| Dates | Registration Date | Update | Reinstatement | 10/12/2018 2:58:33 PM | 1/11/2021 10:38:58 AM | 1/21/2021 1:53 PM |
| Dates | Signed By Date | Update | Reinstatement | 10/12/2018 4:28:10 PM | 1/11/2021 1:40:34 PM | 1/21/2021 1:53 PM |
| Dates | Start Date | Update | Reinstatement | 1/1/2019 12:00:00 AM | 4/1/2021 12:00:00 AM | 1/21/2021 1:53 PM |
| Terminations | Termination Comments | Update | Reinstatement | Termination based on filing of 2019 MCR | | 1/21/2021 1:53 PM |
| Terminations | Termination Date | Update | Reinstatement | 10/1/2020 12:00:00 AM | | 1/21/2021 1:53 PM |
| Terminations | Termination Effective Date | Update | Reinstatement | 8/31/2020 12:00:00 AM | | 1/21/2021 1:53 PM |
| Terminations | Termination Reason | Update | Reinstatement | DSH percentage below statutory minimum | | 1/21/2021 1:53 PM |
| Details | Comments Public | Insert | Reinstatement | | Participated starting 1/1/2019, terminated 10/1/2020. Reinstated 4/1/2021. | 1/21/2021 1:49 PM |
| Details | Comments Public | Insert | Reinstatement | | Participated starting 1/1/2019, terminated 10/1/2020. Reinstated 4/1/2020. | 1/21/2021 12:11 PM |
| Details | State | Update | | To Be Terminated | Terminated | 10/1/2020 12:01 AM |
| Dates | Last Date That 340B Drugs Purchased | Update | Recertification | | 8/31/2020 12:00:00 AM | 9/2/2020 9:25 AM |
| Details | State | Update | Recertification | Active | To Be Terminated | 9/2/2020 9:25 AM |
| Terminations | Termination Comments | Update | Recertification | | Termination based on filing of 2019 MCR | 9/2/2020 9:25 AM |
| Terminations | Termination Date | Update | Recertification | | 10/1/2020 12:00:00 AM | 9/2/2020 9:25 AM |
| Terminations | Termination Effective Date | Update | Recertification | | 8/31/2020 12:00:00 AM | 9/2/2020 9:25 AM |
| Terminations | Termination Reason | Update | Recertification | | DSH percentage below statutory minimum | 9/2/2020 9:25 AM |
| Contacts | Primary Contact | Update | Profile Change Request | Houchin, Cynthia
340 Coordinator
Community Hospital
9706443182 | Houchin, Cynthia
340B Coordinator
Community Hospital
9706443552 | 3/11/2020 10:34 AM |
| Contacts | Primary Contact | Update | Change Request | Buniger, Amie
Project Manager
Community Hospital
9706443182 | Houchin, Cynthia
340 Coordinator
Community Hospital
9706443182 | 1/2/2020 2:54 PM |
| Details | Last Recertification Date | Update | Recertification | | 8/28/2019 7:22:33 AM | 8/28/2019 7:22 AM |
| Details | State | Update | | Approved | Active | 1/1/2019 12:05 AM |
| Addresses | Shipping Address | Delete | Reinstatement | Coloardo West Healthcare
2373 G Road
STE 120
Grand Junction, CO 81505-9641 | | 11/26/2018 7:44 AM |
| Addresses | Shipping Address | Insert | Reinstatement | | Coloardo West Healthcare System dba Canyon View Pharmacy
2373 G Road
STE 120
Grand Junction, CO 81505-9641 | 11/26/2018 7:44 AM |
| Dates | Participating Approval Date | Update | Reinstatement | | 11/26/2018 7:44:20 AM | 11/26/2018 7:44 AM |
| Details | State | Update | Reinstatement | Pending | Approved | 11/26/2018 7:44 AM |
| Dates | Signed By Date | Update | Reinstatement | 4/13/2017 12:00:00 AM | 10/12/2018 4:28:10 PM | 11/26/2018 7:44 AM |
| Dates | Start Date | Update | Reinstatement | | 1/1/2019 12:00:00 AM | 11/26/2018 7:44 AM |
| Details | Comments Public | Insert | Reinstatement | | Participated starting 7/1/2017, terminated 10/1/2018. Reinstated 1/1/2019. | 11/23/2018 9:56 AM |
| Addresses | Main Address | Update | Recertification |
2351 G RD
GRAND JUNCTION, CO 81505-9641 |
2351 G ROAD
GRAND JUNCTION, CO 81505 | 10/12/2018 6:58 PM |
| Details | Last Recertification Date | Update | Reinstatement | 11/15/2017 3:47:18 PM | | 10/12/2018 2:58 PM |
| Dates | Last Date That 340B Drugs Purchased | Update | Reinstatement | 7/20/2018 12:00:00 AM | | 10/12/2018 2:58 PM |
| Dates | Participating Approval Date | Update | Reinstatement | 4/28/2017 12:00:00 AM | | 10/12/2018 2:58 PM |
| Details | State | Update | Reinstatement | Terminated | Pending | 10/12/2018 2:58 PM |
| Dates | Registration Date | Update | Reinstatement | 4/13/2017 12:00:00 AM | 10/12/2018 2:58:33 PM | 10/12/2018 2:58 PM |
| Dates | Start Date | Update | Reinstatement | 7/1/2017 12:00:00 AM | | 10/12/2018 2:58 PM |
| Terminations | Termination Comments | Update | Reinstatement | Please refer to submitted self-disclosure for further details. | | 10/12/2018 2:58 PM |
| Terminations | Termination Date | Update | Reinstatement | 10/1/2018 12:00:00 AM | | 10/12/2018 2:58 PM |
| Terminations | Termination Effective Date | Update | Reinstatement | 5/31/2018 12:00:00 AM | | 10/12/2018 2:58 PM |
| Terminations | Termination Reason | Update | Reinstatement | DSH percentage below statutory minimum | | 10/12/2018 2:58 PM |
| Details | State | Update | | To Be Terminated | Terminated | 10/1/2018 12:05 AM |
| Dates | Last Date That 340B Drugs Purchased | Update | Recertification | | 7/20/2018 12:00:00 AM | 8/24/2018 3:53 PM |
| Details | State | Update | Recertification | Active | To Be Terminated | 8/24/2018 3:53 PM |
| Terminations | Termination Comments | Update | Recertification | | Please refer to submitted self-disclosure for further details. | 8/24/2018 3:53 PM |
| Terminations | Termination Date | Update | Recertification | | 10/1/2018 12:00:00 AM | 8/24/2018 3:53 PM |
| Terminations | Termination Effective Date | Update | Recertification | | 5/31/2018 12:00:00 AM | 8/24/2018 3:53 PM |
| Terminations | Termination Reason | Update | Recertification | | DSH percentage below statutory minimum | 8/24/2018 3:53 PM |
| Addresses | Shipping Address | Insert | Change Request | | Coloardo West Healthcare
2373 G Road
STE 120
Grand Junction, CO 81505-9641 | 6/5/2018 12:18 PM |
| Addresses | Shipping Address | Delete | Change Request | Coloardo West Healthcare System dba Canyon View Pharmacy
2373 G Road
STE 120
Grand Junction, CO 81505-9641 | | 6/5/2018 12:18 PM |
| Details | Last Recertification Date | Update | Recertification | | 11/15/2017 3:47:18 PM | 11/15/2017 3:47 PM |
| Contacts | Authorizing Official | Update | | Thomas, Christian A.
CEO
9706443011 | Thomas, Christian A.
CEO
Community Hospital
9706443011 | 9/19/2017 5:42 PM |
| Contacts | Signed By | Update | | Thomas, Christian A.
CEO
9706443011 | Thomas, Christian A.
CEO
Community Hospital
9706443011 | 9/19/2017 5:42 PM |
| Contacts | Primary Contact | Update | | Buniger, Amie
Project Manager
9706443182 | Buniger, Amie
Project Manager
Community Hospital
9706443182 | 9/19/2017 2:37 PM |
| Addresses | Shipping Address | Delete | | Community Hospital Pharmacy
2351 G RD
Grand Junction, CO 81505-9641 | | 5/3/2017 1:10 PM |
| Addresses | Shipping Address | Delete | | Grand Valley Oncology
2596 Patterson Road
Grand Junction, CO 81505-1439 | | 5/3/2017 1:10 PM |
| Addresses | Main Address | Insert | | |
2351 G RD
GRAND JUNCTION, CO 81505-9641 | 5/3/2017 1:10 PM |
| Addresses | Billing Address | Insert | | | Colorado West Healthcare System dba Community Hospital
2004 N 12th Street
Grand Junction, CO 81501 | 5/3/2017 1:10 PM |
| Addresses | Shipping Address | Insert | | | Community Hospital Pharmacy
2351 G RD
Grand Junction, CO 81505-9641 | 5/3/2017 1:10 PM |
| Addresses | Shipping Address | Insert | | | Coloardo West Healthcare System dba Canyon View Pharmacy
2373 G Road
STE 120
Grand Junction, CO 81505-9641 | 5/3/2017 1:10 PM |
| Addresses | Shipping Address | Insert | | | Grand Valley Oncology
2596 Patterson Road
Grand Junction, CO 81505-1439 | 5/3/2017 1:10 PM |
| Contacts | Primary Contact | Insert | | | Buniger, Amie
Project Manager
9706443182 | 5/3/2017 1:10 PM |
| Contacts | Authorizing Official | Insert | | | Thomas, Christian A.
CEO
9706443011 | 5/3/2017 1:10 PM |
| Contacts | Signed By | Insert | | | Thomas, Christian A.
CEO
9706443011 | 5/3/2017 1:10 PM |
| Dates | Participating Approval Date | Update | | | 4/28/2017 12:00:00 AM | 4/28/2017 12:48 PM |
| Details | State | Update | | Pending | Active | 4/28/2017 12:48 PM |
| Dates | Start Date | Update | | | 7/1/2017 12:00:00 AM | 4/28/2017 12:48 PM |
| Details | 340B ID | Update | | ONLINE_REG_76928 | DSH060054 | 4/28/2017 9:29 AM |
| Details | 340B ID | Update | | | ONLINE_REG_76928 | 4/13/2017 4:42 PM |
| Medicaid Billing | Medicaid: Is Primary | Insert | | | False | 4/13/2017 4:42 PM |
| Medicaid Billing | Medicaid: Number | Insert | | | 5054002 | 4/13/2017 4:42 PM |
| Medicaid Billing | Medicaid: State | Insert | | | CO | 4/13/2017 4:42 PM |
| Medicaid Billing | NPI: Number | Insert | | | 1497723407 | 4/13/2017 4:42 PM |
| Details | Last Recertification Date | Insert | | | | 4/13/2017 4:42 PM |
| Details | Grant Number | Insert | | | | 4/13/2017 4:42 PM |
| Details | 340B ID | Insert | | | | 4/13/2017 4:42 PM |
| Details | Is Authorizing Official EHB Data | Insert | | | | 4/13/2017 4:42 PM |
| Dates | Last Date That 340B Drugs Purchased | Insert | | | | 4/13/2017 4:42 PM |
| Details | Medicare Provider Number | Insert | | | 060054 | 4/13/2017 4:42 PM |
| Details | Entity Name | Insert | | | COMMUNITY HOSPITAL | 4/13/2017 4:42 PM |
| Details | Program Code | Insert | | | DSH | 4/13/2017 4:42 PM |
| Details | Entity Subname | Insert | | | | 4/13/2017 4:42 PM |
| Dates | Participating Approval Date | Insert | | | | 4/13/2017 4:42 PM |
| Details | State | Insert | | | Pending | 4/13/2017 4:42 PM |
| Dates | Registration Date | Insert | | | 4/13/2017 12:00:00 AM | 4/13/2017 4:42 PM |
| Dates | Signed By Date | Insert | | | 4/13/2017 12:00:00 AM | 4/13/2017 4:42 PM |
| Dates | Start Date | Insert | | | | 4/13/2017 4:42 PM |
| Terminations | Termination Comments | Insert | | | | 4/13/2017 4:42 PM |
| Terminations | Termination Date | Insert | | | | 4/13/2017 4:42 PM |
| Terminations | Termination Effective Date | Insert | | | | 4/13/2017 4:42 PM |
| Terminations | Termination Reason | Insert | | | | 4/13/2017 4:42 PM |