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SCH460019-00 Uintah Basin Medical Center (Active)
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Main Details
Name
Uintah Basin Medical Center
Subdivision Name
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH460019-00
Medicare Provider Number
460019
Additional Details
Current Program Status
Active
Registration Date
5/30/2012
Participating Start Date
7/1/2012
Participating Approval Date
6/18/2012
Last Recertification Date
8/12/2024
Contacts
Authorizing Official
Uintah Basin Medical Center
Brent Hales, CFO
(435) 722-6164
Primary Contact
Uintah Basin Medical Center
Weston Ross Weaver, Outpatient Pharmacy Manager
(435) 722-4691 Ext: 2054
Addresses
Street Address
250 West 300 North
Roosevelt, UT 84066
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Last Updated On
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The 340B ID for this entity was inadvertently modified on 2/25/2013; the error was detected and the original ID restored on 3/11/2013. The entity was continuously registered for the 340B program during this period. [TL]
03/26/2013
April 2025
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