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DSH060011AQ DENVER HEALTH MEDICAL CENTER (Terminated)
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Main Details
Name
DENVER HEALTH MEDICAL CENTER
Subdivision Name
Mental Health Centers of Denver
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH060011AQ
Medicare Provider Number
060011
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/13/2016
Participating Start Date
4/1/2016
Participating Approval Date
3/8/2016
Last Recertification Date
8/29/2022
Termination Date
Termination Reason
4/1/2023
Change of covered entity type (non-hospital)
Contacts
Authorizing Official
Denver Health and Hospital Authority
Kris Gaw, Chief Operating Officer
(303) 602-4985
Primary Contact
Denver Health and Hospital Authority
Nathalie Seoldo-Hinman, Admin Director of Pharmacy Services
(303) 602-9211
Addresses
Street Address
4455 East 12th Avenue
Denver, CO 80220
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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