340B Drug Pricing Program Database
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DSH020001 PROVIDENCE ALASKA MEDICAL CENTER (Active)
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Main Details
Name
PROVIDENCE ALASKA MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH020001
Medicare Provider Number
020001
Additional Details
Current Program Status
Active
Registration Date
4/14/2008
Participating Start Date
7/1/2005
Participating Approval Date
4/14/2008
Last Recertification Date
8/23/2024
Contacts
Authorizing Official
Providence Alaska Medical Center
AMY MILLER, Chief Financial Officer, ALASKA
(907) 212-6503
Primary Contact
Providence Alaska Medical Center
Karen Elizabeth Thompson, Sr. Manager Pharmacy
(907) 212-4826
Addresses
Street Address
3200 PROVIDENCE DRIVE
ANCHORAGE, AK 99508
Billing Address
Providence St. Joseph
PO Box 31263
Salt Lake City, UT 84131
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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