340B Drug Pricing Program Database
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DSH460009AB University of Utah (Active)
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Main Details
Name
University of Utah
Subdivision Name
Utah Diabetes and Endocrinology Center
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH460009AB
Medicare Provider Number
460009
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/4/2012
Participating Start Date
1/1/2013
Participating Approval Date
10/18/2012
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
University of Utah Hospitals and Clinics
Charlton Gordon Park, Chief Financial Officer
(801) 585-1325
Primary Contact
University of Utah Hospitals and Clinics
Anthony Trovato, 340B Clinical Pharmacist
(801) 585-9139
Addresses
Street Address
615 Arapeen Drive
Ste 100
Salt Lake City, UT 84108-1239
Billing Address
University of Utah Hospital
Accounts Payable
PO Box 2790
Salt Lake City, UT 84110-2790
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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