340B Drug Pricing Program Database
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DSH130006GG ST LUKES REGIONAL MEDICAL CENTER, LTD. (Terminated)
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Main Details
Name
ST LUKES REGIONAL MEDICAL CENTER, LTD.
Subdivision Name
SLC Boise Surgical Group Meridian / NICA BOISE SURGICAL GROUP - NAMPA HAWAII
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH130006GG
Medicare Provider Number
130006
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/1/2015
Participating Start Date
10/1/2015
Participating Approval Date
7/16/2015
Last Recertification Date
8/18/2016
Termination Date
Termination Reason
1/1/2018
Never implemented the 340B Program
Contacts
Authorizing Official
St. Lukes Regional Medical Center
Peter DiDio, Vice President, Controller
(208) 381-1251
Primary Contact
St. Luke's Health System, LTD
Amanda Davis, Pharmacy Business Analyst
(208) 706-1021
Addresses
Street Address
215 E HAWAII AVENUE
Nampa, ID 83686
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
June 2025
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