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PED063301-33 Children's Hospital Colorado (Active)
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Main Details
Name
Children's Hospital Colorado
Subdivision Name
Children's Hospital Colorado - Wheat Ridge Orthopedic Care
Type
Children's Hospital
Rural
No
340B ID
PED063301-33
Medicare Provider Number
063301
Outpatient Facility Provider Number
063301
Additional Details
Current Program Status
Active
Registration Date
7/14/2014
Participating Start Date
10/1/2014
Participating Approval Date
9/8/2014
Last Recertification Date
9/4/2024
Contacts
Authorizing Official
Children's Hospital Colorado
Casey Dugan, Vice President of Pharmacy Services
(720) 777-5683
Primary Contact
Children's Hospital Colorado
Ricardo Alexis Laremont, Pharmacy 340B Program Manager
(720) 777-8899
Addresses
Street Address
3455 Lutheran Pkwy
Suite 230
Wheat Ridge, CO 80033
Billing Address
Children's Hospital Colorado
13123 E 16th Av
Aurora, CO 80045
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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