340B Drug Pricing Program Database
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DSH060031J Penrose Hospital (Active)
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Main Details
Name
Penrose Hospital
Subdivision Name
St. Francis Medical Center - Electrocardiology
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH060031J
Medicare Provider Number
060031
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/28/2017
Participating Start Date
7/1/2017
Participating Approval Date
5/8/2017
Last Recertification Date
9/4/2024
Contacts
Authorizing Official
Penrose St. Francis Health Services
Kevin Wikoff, Market CFO
(719) 571-2498
Primary Contact
CommonSpirit Health
Samantha Morgan, System Manager, 340B Mountain Region
(303) 673-7380
Addresses
Street Address
6001 E Woodmen Rd
Colorado Springs, CO 80923
Billing Address
CommonSpirit Health
PO Box 372660
Denver, CO 80237
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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