340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
DSH460009AC University of Utah (Terminated)
Print
Main Details
Name
University of Utah
Subdivision Name
Midvalley Health Center / Moran Eye Center
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH460009AC
Medicare Provider Number
460009
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
11/3/2015
Participating Start Date
1/1/2016
Participating Approval Date
11/9/2015
Last Recertification Date
9/5/2023
Termination Date
Termination Reason
1/1/2024
Business decision by the Covered Entity
Contacts
Authorizing Official
University of Utah Hospitals and Clinics
Charlton Gordon Park, Chief Financial Officer
(801) 585-1325
Primary Contact
University of Utah Hospitals and Clinics
Dallas Moore, Associate Chief Pharmacy Officer
(801) 585-2188
Addresses
Street Address
243 East 6100 South
Murray, UT 84107-7302
Billing Address
University of Utah Hospital
Accounts Payable
PO Box 2790
Salt Lake City, UT 84110-2790
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
No records to display.
April 2025
April 2025
week
S
M
T
W
T
F
S
14
30
31
1
2
3
4
5
15
6
7
8
9
10
11
12
16
13
14
15
16
17
18
19
17
20
21
22
23
24
25
26
18
27
28
29
30
1
2
3
19
4
5
6
7
8
9
10
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