340B Drug Pricing Program Database
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DSH320021CB PRESBYTERIAN HOSPITAL (Active)
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Main Details
Name
PRESBYTERIAN HOSPITAL
Subdivision Name
PMG San Mateo Internal Medicine
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH320021CB
Medicare Provider Number
320021
Outpatient Facility Provider Number
320021
Additional Details
Current Program Status
Active
Registration Date
7/14/2014
Participating Start Date
10/1/2014
Participating Approval Date
9/4/2014
Last Recertification Date
9/6/2024
Contacts
Authorizing Official
Presbyterian Healthcare Services
Erica Downing, VP, Pharmacy and Infusion Services & Chief Pharmacy Officer
(505) 724-8994
Primary Contact
Presbyterian Healthcare Services
Barbara Fried-Smith, 340B Program Coordinator
(505) 886-4820
Addresses
Street Address
401 San Mateo SE
Albuquerque, NM 87108
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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