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SCH060006-02 MONTROSE MEMORIAL HOSPITAL (Terminated)
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Main Details
Name
MONTROSE MEMORIAL HOSPITAL
Subdivision Name
Mountain View Therapy Center for Wellness Wound Care
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH060006-02
Medicare Provider Number
060006
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/6/2016
Participating Start Date
10/1/2016
Participating Approval Date
8/8/2016
Last Recertification Date
Termination Date
Termination Reason
10/1/2016
Failure to recertify
Contacts
Authorizing Official
Montrose Memorial Hospital
Larry Dupper, CFO
(970) 252-2659
Primary Contact
Brandee Larkin, Interim Pharmacy Director
(970) 240-7259
Addresses
Street Address
815 S 4th St
Montrose, CO 81401
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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