340B Drug Pricing Program Database
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DSH130006D ST LUKES REGIONAL MEDICAL CENTER, LTD. (Active)
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Main Details
Name
ST LUKES REGIONAL MEDICAL CENTER, LTD.
Subdivision Name
ST LUKES MERIDIAN MEDICAL CENTER (SLMMC)
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH130006D
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
8/29/2024
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
520 S EAGLE ROAD
MERIDIAN, ID 83642
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
June 2025
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