340B Drug Pricing Program Database
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SCH460026-00 IHC HEALTH SERVICES, INC. DBA: Intermountain Health SEVIER VALLEY HOSPITAL (Active)
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Main Details
Name
IHC HEALTH SERVICES, INC. DBA: Intermountain Health SEVIER VALLEY HOSPITAL
Subdivision Name
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH460026-00
Medicare Provider Number
460026
Additional Details
Current Program Status
Active
Registration Date
4/15/2019
Participating Start Date
7/1/2019
Participating Approval Date
5/6/2019
Last Recertification Date
8/14/2024
Contacts
Authorizing Official
Intermountain Healthcare
Vincent Donohue, Finance Director-Central UT Rural
(435) 983-0527
Primary Contact
IHC Health Services, Inc.
Kevin Forbush, 340B Program Director
(385) 429-2887
Addresses
Street Address
1000 NORTH MAIN ST
RICHFIELD, UT 84701
Billing Address
IHC HEALTH SERVICES, INC. DBA: Intermountain Health SEVIER VALLEY HOSPITAL
PO Box 30184
Salt Lake City, UT 84130
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 10/1/2014, terminated 7/1/2018. Reinstated 7/1/2019.
05/02/2019
9/30/14 participating ? thru 9/30/12, not participating 10/1/12 thru 9/30/14, re-instated based on on-line registration submitted in July 2014
09/30/2014
9/29/11 Terminated, reinstated same organization as a DSH with ID DSH460026; 12/3/10 - DOC RECD TO CONFIRM ELIG DSH ADJ %
09/29/2011
09/21/11 participating as DSH(10/1/08 TO 1/1/09) AS SCH (1/1/11 TO 10/1/11) REINSTATED AS DSH 10/1/11
09/21/2011
12/3/10 - DOC RECD TO CONFIRM ELIG DSH ADJ %
06/15/2011
April 2025
April 2025
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