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DSH060010A POUDRE VALLEY HOSPITAL (Active)
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Main Details
Name
POUDRE VALLEY HOSPITAL
Subdivision Name
UC Health - PVH Cancer Care and Hematology Center, Fort Collins
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH060010A
Medicare Provider Number
060010
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/10/2022
Participating Start Date
4/1/2022
Participating Approval Date
2/11/2022
Last Recertification Date
8/14/2024
Contacts
Authorizing Official
Poudre Valley Health Care, Inc.
David Charles Thompson, Chief Financial Officer
(970) 237-7011
Primary Contact
Poudre Valley Health Care, Inc.
Andrew Harmon, Director of Pharmacy
(970) 495-8054
Addresses
Street Address
2121 E HARMONY RD
STE 170
FORT COLLINS, CO 80528-3400
Billing Address
Poudre Valley Health Care, Inc.
2315 E. Harmony Rd.
Suite 200
Fort Collins, CO 80528
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting on 7/1/2017; Terminated on 1/1/2018; Reinstated 4/1/2022.
02/11/2022
May 2025
May 2025
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