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SCH060006-04 MONTROSE MEMORIAL HOSPITAL (Terminated)
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Main Details
Name
MONTROSE MEMORIAL HOSPITAL
Subdivision Name
Mountain View Therapy Center for Wellness
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH060006-04
Medicare Provider Number
060006
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/11/2017
Participating Start Date
4/1/2017
Participating Approval Date
3/15/2017
Last Recertification Date
Termination Date
Termination Reason
10/1/2017
Change of covered entity type
Contacts
Authorizing Official
Montrose Memorial Hospital
Larry Dupper, CFO
(970) 252-2659
Primary Contact
Montrose Memorial Hospital
George Papineau, Director of Pharmacy
(970) 240-7259
Addresses
Street Address
800 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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Participating 10/1/2016 until terminated effective 10/1/2016, reinstated effective 4/1/2016.
01/18/2017
May 2025
May 2025
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