340B Drug Pricing Program Database
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DSH060008 SAN LUIS VALLEY REGIONAL MEDICAL CENTER (Active)
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Main Details
Name
SAN LUIS VALLEY REGIONAL MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH060008
Medicare Provider Number
060008
Additional Details
Current Program Status
Active
Registration Date
4/29/2008
Participating Start Date
10/1/2004
Participating Approval Date
4/29/2008
Last Recertification Date
8/27/2024
Contacts
Authorizing Official
San Luis Valley Regional Medical Center
Konnie Martin, CEO
(719) 587-1202
Primary Contact
San Luis Valley Health
Thomas Robert Wisniewski, Director of Pharmacy
(719) 587-1261
Addresses
Street Address
106 BLANCA AVE
ALAMOSA, CO 81101
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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