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DSH060023 St. Mary's Hospital & Medical Center, Inc dba Intermountain Health St. Mary's Regional Hospital (Active)
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Main Details
Name
St. Mary's Hospital & Medical Center, Inc dba Intermountain Health St. Mary's Regional Hospital
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH060023
Medicare Provider Number
060023
Additional Details
Current Program Status
Active
Registration Date
7/9/2014
Participating Start Date
10/1/2014
Participating Approval Date
8/29/2014
Last Recertification Date
8/20/2024
Contacts
Authorizing Official
Intermountain Healthcare
Vincent Donohue, Finance Director-Central UT Rural
(435) 983-0527
Primary Contact
Intermountain Health
Ben Landry, 340B Pharmacist
(207) 200-5264
Addresses
Street Address
2635 N. 7TH STREET
GRAND JUNCTION, CO 81501
Billing Address
St Mary’s Hospital and Medical Center Inc.
Attn: Accounts Payable
P.O. Box 1010
Lafayette, CO 80026
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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