340B Drug Pricing Program Database
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PED063301-51 Children's Hospital Colorado (Active)
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Main Details
Name
Children's Hospital Colorado
Subdivision Name
CHILDRENS HOSPITAL COLORADO / South Eye Clinic
Type
Children's Hospital
Rural
No
340B ID
PED063301-51
Medicare Provider Number
063301
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/13/2016
Participating Start Date
10/1/2016
Participating Approval Date
8/8/2016
Last Recertification Date
9/4/2024
Contacts
Authorizing Official
Children's Hospital Colorado
Casey Dugan, Vice President of Pharmacy Services
(720) 777-5683
Primary Contact
Children's Hospital Colorado
Ricardo Alexis Laremont, Pharmacy 340B Program Manager
(720) 777-8899
Addresses
Street Address
1811 PLAZA DRIVE
HIGHLANDS RANCH, CO 80129-2450
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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