340B Drug Pricing Program Database
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DSH060012 St. Mary-Corwin Hospital (Active)
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Main Details
Name
St. Mary-Corwin Hospital
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH060012
Medicare Provider Number
060012
Additional Details
Current Program Status
Active
Registration Date
1/8/2014
Participating Start Date
4/1/2014
Participating Approval Date
3/10/2014
Last Recertification Date
9/4/2024
Contacts
Authorizing Official
CommonSpirit
Andrew Burbidge, CFO
(719) 285-2111
Primary Contact
CommonSpirit Health
Samantha Morgan, System Manager, 340B Program
(303) 673-7354
Addresses
Street Address
1008 Minnequa Avenue
Pueblo, CO 81004
Billing Address
CommonSpirit Health
PO Box 372660
Denver, CO 80237
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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