340B Drug Pricing Program Database
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DSH130006C ST LUKES REGIONAL MEDICAL CENTER, LTD. (Active)
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Main Details
Name
ST LUKES REGIONAL MEDICAL CENTER, LTD.
Subdivision Name
ST LUKE'S CANCER INSTITUTE-BOISE/CHEMO INFUSION-BOISE
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH130006C
Medicare Provider Number
130006
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/21/2008
Participating Start Date
10/1/2004
Participating Approval Date
4/21/2008
Last Recertification Date
8/27/2024
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 EAST IDAHO ST
BOISE, ID 83712
Billing Address
St. Lukes Health System, LTD
190 E Bannock
Boise, ID 83712
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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3/19/10 OPA NOTIFIED MEDICAID NUMBER 002251200 WAS LISTED IN ERROR FROM BEGINNING OF PARTICIPATION IN THE 340B PROGRAM.; 6/11/08-REMOVED MEDICAID #(WAS 002251200) 03/20/2014: Termination recorded in error; site remained continuously eligible from participation start date.
03/31/2014
3/19/10 OPA NOTIFIED MEDICAID NUMBER 002251200 WAS LISTED IN ERROR FROM BEGINNING OF PARTICIPATION IN THE 340B PROGRAM.; 6/11/08-REMOVED MEDICAID #(WAS 002251200)
05/14/2012
3/19/10 OPA NOTIFIED MEDICAID NUMBER 002251200 WAS LISTED IN ERROR FROM BEGINNING OF PARTICIPATION IN THE 340B PROGRAM.; 6/11/08-REMOVED MEDICAID #(WAS 002251200)
06/11/2008
3/19/10 OPA NOTIFIED MEDICAID NUMBER 002251200 WAS LISTED IN ERROR FROM BEGINNING OF PARTICIPATION IN THE 340B PROGRAM.; 6/11/08-REMOVED MEDICAID #(WAS 002251200)
04/21/2008
June 2025
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