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HM83712 ST LUKE'S REGIONAL MEDICAL CENTER, LTD (Active)
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Main Details
Name
ST LUKE'S REGIONAL MEDICAL CENTER, LTD
Subdivision Name
ST. LUKE'S HEMOPHILIA CENTER
Type
Comprehensive Hemophilia Treatment Center
340B ID
HM83712
Grant Number
H30MC240491300
Additional Details
Current Program Status
Active
Registration Date
12/14/2006
Participating Start Date
1/1/2007
Participating Approval Date
12/14/2006
Last Recertification Date
2/25/2025
Contacts
Authorizing Official
St. Luke's Health System, LTD
Kate Fowler, Senior VP & CFO
(208) 381-8717
Primary Contact
St. Luke's Health System, LTD
Amanda Davis, Pharmacy Business Analyst
(208) 706-1021
Addresses
Street Address
100 E. IDAHO ST.
BOISE, ID 83712
Billing Address
ST. LUKE'S HEALTH SYSTEM, LTD.
190 E BANNOCK ST.
BOISE, ID 83712
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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4/12/10 OPA NOTIFIED THAT MEDICAID NUMBER WAS LISTED IN ERROR. COVERED ENTITY HAS OPERATED UNDER THE “CARVE-OUT” OPTION SINCE 1/1/2007. REMOVED MEDICAID #(WAS 13-0006)
12/14/2006
May 2025
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