Covered Entity Details

DSH060031E PENROSE/ST. FRANCIS HEALTHCARE (Terminated) - information as of 6/9/2025 11:01:44 PM

Main Details

Name

PENROSE/ST. FRANCIS HEALTHCARE

Subdivision Name

St. Francis Medical Center - Cardiac Rehabilitation

Type

Disproportionate Share Hospital

Rural

Yes

340B ID

DSH060031E

Medicare Provider Number

060031

Outpatient Facility Provider Number

Additional Details

Current Program Status

Terminated

Registration Date

4/28/2017

Participating Start Date

7/1/2017

Participating Approval Date

5/8/2017

Last Recertification Date

9/10/2019

Termination Date
Termination Reason

10/1/2020
Other

Contacts

Authorizing Official

Centura-Penrose St. Francis
Patrick T Ballard, Chief Financial Officer, Penrose-St. Francis Health Services
(719) 776-5911

Primary Contact

Centura-Penrose St. Francis
Alison Schlang, Director of Pharmacy, Penrose-St. Francis Health Services
(719) 776-4489

Addresses

Street Address

6001 E Woodmen Rd
Colorado Springs, CO 80923

Billing Address

Centura Health/AP Dept
PO Box 372660
Denver, CO 80237

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	05031000
		1932112125

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
DSH060031A	Child	DSH	Penrose Hospital	St. Francis Medical Center - Catholic Health Initiatives Colorado Operating Room	6001 E Woodmen Rd	Colorado Springs	CO	Active
DSH060031AA	Child	DSH	Penrose Hospital	St. Francis Medical Center - Ambulatory Care/PACU - PACU	6001 E Woodmen Rd	Colorado Springs	CO	Active
DSH060031AB	Child	DSH	Penrose Hospital	Penrose Cardiology - Cardiology	2222 N NEVADA AVE	COLORADO SPRINGS	CO	Active
DSH060031AC	Child	DSH	Penrose Hospital	Wound Care - Wound Care	2222 N NEVADA AVE	COLORADO SPRINGS	CO	Active
DSH060031AD	Child	DSH	Penrose Hospital	ED OBSERVATION UNIT - ED OBSERVATION UNIT	2222 N NEVADA AVE	COLORADO SPRINGS	CO	Active
DSH060031AE	Child	DSH	Penrose Hospital	MRI - MRI	2222 N NEVADA AVE	COLORADO SPRINGS	CO	Active
DSH060031AF	Child	DSH	Penrose Hospital	RADIOISOTOPE - RADIOISOTOPE	2222 N NEVADA AVE	COLORADO SPRINGS	CO	Active
DSH060031AG	Child	DSH	Penrose Hospital	RESPIRATORY THERAPY - RESPIRATORY THERAPY	2222 N NEVADA AVE	COLORADO SPRINGS	CO	Active
DSH060031AH	Child	DSH	Penrose Hospital	RENAL DIALYSIS - RENAL DIALYSIS	2222 N NEVADA AVE	COLORADO SPRINGS	CO	Active
DSH060031AJ	Child	DSH	Penrose Hospital	LABORATORY - LABORATORY	2222 N NEVADA AVE	COLORADO SPRINGS	CO	Active
DSH060031AK	Child	DSH	Penrose Hospital	RADIOLOGY-THERAPEUTIC - RADIOLOGY-THERAPEUTIC	2222 N NEVADA AVE	COLORADO SPRINGS	CO	Active
DSH060031AL	Child	DSH	Penrose Hospital	SLEEP CENTER - SLEEP CENTER	2222 N NEVADA AVE	COLORADO SPRINGS	CO	Active
DSH060031B	Child	DSH	Penrose Hospital	St. Francis Medical Center - Emergency Room	6001 E Woodmen Rd	Colorado Springs	CO	Active
DSH060031C	Child	DSH	PENROSE/ST. FRANCIS HEALTHCARE	St. Francis Medical Center - Women's Surgery Center	6001 E Woodmen Rd	Colorado Springs	CO	Terminated
DSH060031D	Child	DSH	PENROSE/ST. FRANCIS HEALTHCARE	St. Francis Medical Center - Wound Clinic	6001 E Woodmen Rd	Colorado Springs	CO	Terminated
DSH060031E	Child	DSH	PENROSE/ST. FRANCIS HEALTHCARE	St. Francis Medical Center - Cardiac Rehabilitation	6001 E Woodmen Rd	Colorado Springs	CO	Terminated
DSH060031F	Child	DSH	Penrose Hospital	St. Francis Medical Center - Gastro Intestinal Services-GI LAB	6001 E Woodmen Rd	Colorado Springs	CO	Active
DSH060031G	Child	DSH	PENROSE/ST. FRANCIS HEALTHCARE	St. Francis Medical Center - Sleep Center	6001 E Woodmen Rd	Colorado Springs	CO	Terminated
DSH060031H	Child	DSH	PENROSE/ST. FRANCIS HEALTHCARE	St. Francis Medical Center - Renal Dialysis	6001 E Woodmen Rd	Colorado Springs	CO	Terminated
DSH060031J	Child	DSH	Penrose Hospital	St. Francis Medical Center - Electrocardiology	6001 E Woodmen Rd	Colorado Springs	CO	Active
DSH060031K	Child	DSH	PENROSE/ST. FRANCIS HEALTHCARE	St. Francis Medical Center - Speech Pathology	6001 E Woodmen Rd	Colorado Springs	CO	Terminated
DSH060031L	Child	DSH	PENROSE/ST. FRANCIS HEALTHCARE	St. Francis Medical Center - Physical Therapy	6001 E Woodmen Rd	Colorado Springs	CO	Terminated
DSH060031M	Child	DSH	PENROSE/ST. FRANCIS HEALTHCARE	St. Francis Medical Center - Respiratory Therapy	6001 E Woodmen Rd	Colorado Springs	CO	Terminated
DSH060031N	Child	DSH	PENROSE/ST. FRANCIS HEALTHCARE	St. Francis Medical Center - Blood Bank	6001 E Woodmen Rd	Colorado Springs	CO	Terminated
DSH060031P	Child	DSH	PENROSE/ST. FRANCIS HEALTHCARE	St. Francis Medical Center - Laboratory	6001 E Woodmen Rd	Colorado Springs	CO	Terminated
DSH060031Q	Child	DSH	Penrose Hospital	St. Francis Medical Center - Cardiac Catheterization	6001 E Woodmen Rd	Colorado Springs	CO	Active
DSH060031R	Child	DSH	PENROSE/ST. FRANCIS HEALTHCARE	St. Francis Medical Center - Magnetic Resonance Imaging (MRI)	6001 E Woodmen Rd	Colorado Springs	CO	Terminated
DSH060031S	Child	DSH	Penrose Hospital	St. Francis Medical Center - CT Scan	6001 E Woodmen Rd	Colorado Springs	CO	Active
DSH060031T	Child	DSH	Penrose Hospital	Radioisotope	6001 E Woodmen Rd	Colorado Springs	CO	Active
DSH060031U	Child	DSH	Penrose Hospital	SFMC Ultrasound	6001 E Woodmen Rd	Colorado Springs	CO	Active
DSH060031V	Child	DSH	Penrose Hospital	Radiology-Diagnostic	6001 E Woodmen Rd	Colorado Springs	CO	Active
DSH060031W	Child	DSH	Penrose Hospital	Delivery Room & Labor Room	6001 E Woodmen Rd	Colorado Springs	CO	Active
DSH060031X	Child	DSH	Penrose Hospital	St. Francis Medical Center - Infusion Therapy - Infusion Therapy	6001 E Woodmen Rd	Colorado Springs	CO	Active
DSH060031Y	Child	DSH	PENROSE/ST. FRANCIS HEALTHCARE	St. Francis Medical Center - Electro Physiology Lab - SFMC Electro Physiology Lab	6001 E Woodmen Rd	Colorado Springs	CO	Terminated
DSH060031Z	Child	DSH	PENROSE/ST. FRANCIS HEALTHCARE	St. Francis Medical Center - Special Procedures - SFMC Special Procedures	6001 E Woodmen Rd	Colorado Springs	CO	Terminated

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	State	Update		To Be Terminated	Terminated	10/1/2020 12:01 AM
Dates	Last Date That 340B Drugs Purchased	Update	Recertification		8/28/2020 12:00:00 AM	9/2/2020 7:31 AM
Details	State	Update	Recertification	Active	To Be Terminated	9/2/2020 7:31 AM
Terminations	Termination Comments	Update	Recertification		Location is a part of Audobon facility, not a part of parent organization cost report	9/2/2020 7:31 AM
Terminations	Termination Date	Update	Recertification		10/1/2020 12:00:00 AM	9/2/2020 7:31 AM
Terminations	Termination Effective Date	Update	Recertification		8/28/2020 12:00:00 AM	9/2/2020 7:31 AM
Terminations	Termination Reason	Update	Recertification		Other	9/2/2020 7:31 AM
Addresses	Billing Address	Insert	Change Request		Centura Health/AP Dept PO Box 372660 Denver, CO 80237	9/24/2019 7:44 PM
Details	Last Recertification Date	Update	Recertification	8/20/2018 1:34:50 PM	9/10/2019 10:08:49 AM	9/10/2019 10:08 AM
Details	Last Recertification Date	Update	Recertification	11/8/2017 12:23:28 PM	8/20/2018 1:34:50 PM	8/20/2018 1:34 PM
Contacts	Authorizing Official	Update	Change Request	Sabin, Margaret CEO, Penrose-St. Francis Health Services Centura-Penrose St. Francis Health Services 7197765007	Ballard, Patrick T Chief Financial Officer, Penrose-St. Francis Health Services Centura-Penrose St. Francis 7197765911	5/23/2018 4:14 PM
Details	Last Recertification Date	Update	Recertification		11/8/2017 12:23:28 PM	11/8/2017 12:23 PM
Contacts	Authorizing Official	Update		Sabin, Margaret CEO, Penrose-St. Francis Health Services 7197765007	Sabin, Margaret CEO, Penrose-St. Francis Health Services Centura-Penrose St. Francis Health Services 7197765007	11/8/2017 12:11 PM
Contacts	Signed By	Update		Sabin, Margaret CEO, Penrose-St. Francis Health Services 7197765007	Sabin, Margaret CEO, Penrose-St. Francis Health Services Centura-Penrose St. Francis Health Services 7197765007	11/8/2017 12:11 PM
Contacts	Primary Contact	Update		Schlang, Alison Director of Pharmacy, Penrose-St. Francis Health Services 7197764489	Schlang, Alison Director of Pharmacy, Penrose-St. Francis Health Services Centura-Penrose St. Francis 7197764489	10/20/2017 4:49 PM
Addresses	Main Address	Insert			6001 E Woodmen Rd Colorado Springs, CO 80923	5/8/2017 5:41 PM
Contacts	Authorizing Official	Insert			Sabin, Margaret CEO, Penrose-St. Francis Health Services 7197765007	5/8/2017 5:41 PM
Contacts	Signed By	Insert			Sabin, Margaret CEO, Penrose-St. Francis Health Services 7197765007	5/8/2017 5:41 PM
Contacts	Primary Contact	Insert			Schlang, Alison Director of Pharmacy, Penrose-St. Francis Health Services 7197764489	5/8/2017 5:41 PM
Dates	Participating Approval Date	Update			5/8/2017 12:00:00 AM	5/8/2017 5:38 PM
Details	State	Update		Pending	Active	5/8/2017 5:38 PM
Dates	Start Date	Update			7/1/2017 12:00:00 AM	5/8/2017 5:38 PM
Details	340B ID	Update		OUTPATIENT_ONLINE_REG_77529	DSH060031E	5/2/2017 11:02 AM
Details	340B ID	Update			OUTPATIENT_ONLINE_REG_77529	4/28/2017 12:43 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	4/28/2017 12:43 PM
Medicaid Billing	Medicaid: Number	Insert			05031000	4/28/2017 12:43 PM
Medicaid Billing	Medicaid: State	Insert			CO	4/28/2017 12:43 PM
Medicaid Billing	NPI: Number	Insert			1932112125	4/28/2017 12:43 PM
Details	Last Recertification Date	Insert				4/28/2017 12:43 PM
Details	Grant Number	Insert				4/28/2017 12:43 PM
Details	340B ID	Insert				4/28/2017 12:43 PM
Details	Is Authorizing Official EHB Data	Insert				4/28/2017 12:43 PM
Dates	Last Date That 340B Drugs Purchased	Insert				4/28/2017 12:43 PM
Details	Medicare Provider Number	Insert			060031	4/28/2017 12:43 PM
Details	Entity Name	Insert			PENROSE/ST. FRANCIS HEALTHCARE	4/28/2017 12:43 PM
Details	Program Code	Insert			DSH	4/28/2017 12:43 PM
Details	Entity Subname	Insert			St. Francis Medical Center - Cardiac Rehabilitation	4/28/2017 12:43 PM
Dates	Participating Approval Date	Insert				4/28/2017 12:43 PM
Details	State	Insert			Pending	4/28/2017 12:43 PM
Dates	Registration Date	Insert			4/28/2017 12:00:00 AM	4/28/2017 12:43 PM
Dates	Signed By Date	Insert			4/28/2017 12:00:00 AM	4/28/2017 12:43 PM
Dates	Start Date	Insert				4/28/2017 12:43 PM
Terminations	Termination Comments	Insert				4/28/2017 12:43 PM
Terminations	Termination Date	Insert				4/28/2017 12:43 PM
Terminations	Termination Effective Date	Insert				4/28/2017 12:43 PM
Terminations	Termination Reason	Insert				4/28/2017 12:43 PM