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SCH460019-06 Uintah Basin Medical Center (Approved)
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Main Details
Name
Uintah Basin Medical Center
Subdivision Name
UINTAH BASIN MEDICAL CENTER - Vernal Clinic
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH460019-06
Medicare Provider Number
460019
Outpatient Facility Provider Number
Additional Details
Current Program Status
Approved
Registration Date
4/14/2025
Participating Start Date
7/1/2025
Participating Approval Date
5/8/2025
Last Recertification Date
Contacts
Authorizing Official
Uintah Basin Medical Center
Brent Hales, CFO
(435) 722-6164
Primary Contact
Uintah Basin Medical Center
Weston Ross Weaver, Outpatient Pharmacy Manager
(435) 722-4691 Ext: 2054
Addresses
Street Address
405 N 500 W
VERNAL, UT 84078-1907
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
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