340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
DSH320021B PRESBYTERIAN HOSPITAL (Terminated)
Print
Main Details
Name
PRESBYTERIAN HOSPITAL
Subdivision Name
PMG CEDAR CLINIC
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH320021B
Medicare Provider Number
320021
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
12/6/2005
Participating Start Date
12/8/2005
Participating Approval Date
12/8/2005
Last Recertification Date
8/23/2019
Termination Date
Termination Reason
7/1/2020
Site closure
Contacts
Authorizing Official
Presbyterian Healthcare Services
David Scott Graham, VP-PDS Clinical Support Srvc
(505) 841-1872
Primary Contact
Presbyterian Healthcare Services
Kelly Green, 340B Program Manager
(505) 724-7761
Addresses
Street Address
201 CEDAR SE
SUITE 4630
ALBUQUERQUE, NM 87106
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History
1
Item
1
to
1
of
1
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
1
to
1
of
1
Page:
of 1
Go
Page size:
Change
03/20/2014: Termination recorded in error; site remained continuously eligible from participation start date.
03/31/2014
April 2025
April 2025
week
S
M
T
W
T
F
S
14
30
31
1
2
3
4
5
15
6
7
8
9
10
11
12
16
13
14
15
16
17
18
19
17
20
21
22
23
24
25
26
18
27
28
29
30
1
2
3
19
4
5
6
7
8
9
10
NoFilter
Contains
DoesNotContain
StartsWith
EndsWith
EqualTo
NotEqualTo
GreaterThan
LessThan
GreaterThanOrEqualTo
LessThanOrEqualTo
Between
NotBetween
IsEmpty
NotIsEmpty
IsNull
NotIsNull
Custom
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session