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DSH460007 IHC Health Services Inc. DBA Intermountain Health Cedar City Hospital (Active)
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Main Details
Name
IHC Health Services Inc. DBA Intermountain Health Cedar City Hospital
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH460007
Medicare Provider Number
460007
Additional Details
Current Program Status
Active
Registration Date
6/4/2020
Participating Start Date
7/1/2020
Participating Approval Date
6/11/2020
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
Intermountain Healthcare Cedar City Hospital
Craig Dale Corry, Finance Director
(435) 868-5819
Primary Contact
Intermountain Health
Ben Landry, 340B Pharmacist
(207) 200-5264
Addresses
Street Address
1303 NORTH MAIN ST
CEDAR CITY, UT 84721
Billing Address
IHC Health Services Inc. DBA Intermountain Health Cedar City Hospital
PO BOX 30184
SALT LAKE CITY, UT 84604
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participating start date 10/1/2015; Terminated 7/1/2019; Reinstated 7/1/2020.
06/10/2020
8/19/15 Participated starting 9/1/2008, terminated 5/8/2014 through 9/30/15 while participating in the program as SCH460007-00 4/1/14 thru 9/30/15, reinstated based on new registration submitted in July 2015; 05/08/14- CE changed from DSH to SCH, DSH 340B designation terminated effective 05/08/14.SCH application was approved 04/01/14. 12/7/09 - DOC RECD TO CONFIRM ELIG DSH ADJ %
08/19/2015
05/08/14- CE changed from DSH to SCH, DSH 340B designation terminated effective 05/08/14.SCH application was approved 04/01/14. 12/7/09 - DOC RECD TO CONFIRM ELIG DSH ADJ %
05/08/2014
12/7/09 - DOC RECD TO CONFIRM ELIG DSH ADJ %
12/30/2009
April 2025
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