340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
DSH030016B Banner Casa Grande Medical Center (Terminated)
Print
Main Details
Name
Banner Casa Grande Medical Center
Subdivision Name
DESERT REFLECTIONS IMAGING CENTER
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH030016B
Medicare Provider Number
030016
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/6/2016
Participating Start Date
1/1/2017
Participating Approval Date
11/1/2016
Last Recertification Date
9/5/2018
Termination Date
Termination Reason
7/1/2019
Hospital Outpatient facility no longer eligible
Contacts
Authorizing Official
Banner Ironwood Medical Center
Jeff Allen Buehrle, CFO
(480) 394-4396
Primary Contact
Banner Pharmacy Services
Al Cortese, Sr. Director of Pharmacy
(520) 834-4210
Addresses
Street Address
1828 E FLORENCE BLVD BLDG B STE 118
CASA GRANDE, AZ 85122-4784
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
No records to display.
May 2025
May 2025
week
S
M
T
W
T
F
S
18
27
28
29
30
1
2
3
19
4
5
6
7
8
9
10
20
11
12
13
14
15
16
17
21
18
19
20
21
22
23
24
22
25
26
27
28
29
30
31
23
1
2
3
4
5
6
7
NoFilter
Contains
DoesNotContain
StartsWith
EndsWith
EqualTo
NotEqualTo
GreaterThan
LessThan
GreaterThanOrEqualTo
LessThanOrEqualTo
Between
NotBetween
IsEmpty
NotIsEmpty
IsNull
NotIsNull
Custom
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session