340B Drug Pricing Program Database
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DSH060028A SAINT JOSEPH HOSPITAL (Terminated)
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Main Details
Name
SAINT JOSEPH HOSPITAL
Subdivision Name
SAINT JOSEPH HOSPITAL - Mammography
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH060028A
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
8/23/2023
Termination Date
Termination Reason
10/1/2023
Business decision by the Covered Entity
Contacts
Authorizing Official
Platte Valley Medical Center
Troy Stoehr, VP of Finance
(303) 498-1606
Primary Contact
Intermountain Healthcare
Charles B. Stubbs, 340B Pharmacist
(801) 284-1113
Addresses
Street Address
1825 MARION ST
DENVER, CO 80218-1122
Billing Address
SAINT JOSEPH HOSPITAL
Attn: Accounts Payable
P.O. Box 1010
Lafayette, CO 80026
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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