340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
DSH060023D St. Mary's Hospital & Medical Center, Inc dba Intermountain Health St. Mary's Regional Hospital (Active)
Print
Main Details
Name
St. Mary's Hospital & Medical Center, Inc dba Intermountain Health St. Mary's Regional Hospital
Subdivision Name
ST. MARY'S COUMADIN CLINIC
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH060023D
Medicare Provider Number
060023
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
8/20/2020
Participating Start Date
10/1/2020
Participating Approval Date
8/27/2020
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
2686 PATTERSON ROAD
GRAND JUNCTION, CO 81506-8817
Billing Address
St. Mary's Regional Medical Center
PO Box 1010
Lafayette, CO 80026
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History
1
Item
1
to
1
of
1
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
1
to
1
of
1
Page:
of 1
Go
Page size:
Change
Participating start date 1/1/2016; Terminated 4/1/2020; Reinstated 10/1/2020.
08/24/2020
June 2025
June 2025
week
S
M
T
W
T
F
S
22
25
26
27
28
29
30
31
23
1
2
3
4
5
6
7
24
8
9
10
11
12
13
14
25
15
16
17
18
19
20
21
26
22
23
24
25
26
27
28
27
29
30
1
2
3
4
5
NoFilter
Contains
DoesNotContain
StartsWith
EndsWith
EqualTo
NotEqualTo
GreaterThan
LessThan
GreaterThanOrEqualTo
LessThanOrEqualTo
Between
NotBetween
IsEmpty
NotIsEmpty
IsNull
NotIsNull
Custom
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session