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CAH061319-00 ST. VINCENT GENERAL HOSPITAL (Active)
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Main Details
Name
ST. VINCENT GENERAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH061319-00
Medicare Provider Number
061319
Additional Details
Current Program Status
Active
Registration Date
7/3/2023
Participating Start Date
10/1/2023
Participating Approval Date
7/12/2023
Last Recertification Date
8/15/2024
Contacts
Authorizing Official
St. Vincent Health
Andrew Dreesen, CEO
(719) 486-7161
Primary Contact
St Vincent General Hospital District, dba St. Vincent Health
Kelly Johnston, Interim CFO
(970) 210-2588
Addresses
Street Address
822 WEST 4TH ST.
LEADVILLE, CO 80461
Billing Address
822 West 4th St
822 W 4th St
Leadville, CO 80461
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participating Start Date 1/1/2018,Termination Date 10/1/2021, Reinstatement 10/1/2023
07/12/2023
Participated starting 4/1/2013, terminated 4/1/2017. Reinstated 1/1/2018.
11/24/2017
April 2025
April 2025
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