340B Drug Pricing Program Database
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DSH320021BY PRESBYTERIAN HOSPITAL (Terminated)
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Main Details
Name
PRESBYTERIAN HOSPITAL
Subdivision Name
PMG Pan American Podiatry
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH320021BY
Medicare Provider Number
320021
Outpatient Facility Provider Number
320021
Additional Details
Current Program Status
Terminated
Registration Date
7/14/2014
Participating Start Date
10/1/2014
Participating Approval Date
9/4/2014
Last Recertification Date
9/7/2023
Termination Date
Termination Reason
10/1/2024
Site closure
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
6100 Pan American Freeway NE
Albuquerque, NM 87109
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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