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DSH060028G EXEMPLA SAINT JOSEPH HOSPITAL (Terminated)
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Main Details
Name
EXEMPLA SAINT JOSEPH HOSPITAL
Subdivision Name
BREAST CARE CENTER / Breast Care Center Phys
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH060028G
Medicare Provider Number
060028
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/11/2016
Participating Start Date
7/1/2016
Participating Approval Date
5/5/2016
Last Recertification Date
8/17/2016
Termination Date
Termination Reason
7/1/2017
Site closure
Contacts
Authorizing Official
SCL Health
Karen Scremin, Interim CFO
(303) 813-5255
Primary Contact
SCL Health
Ashley Mains, System Pharmacy Manager - 340B Program
(303) 813-5016
Addresses
Street Address
1825 MARION ST
DENVER, CO 80218-1122
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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