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DSH060010F POUDRE VALLEY HOSPITAL (Terminated)
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Main Details
Name
POUDRE VALLEY HOSPITAL
Subdivision Name
Windsor Imaging
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH060010F
Medicare Provider Number
060010
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
6/10/2017
Participating Start Date
7/1/2017
Participating Approval Date
6/13/2017
Last Recertification Date
Termination Date
Termination Reason
10/1/2017
Site closure
Contacts
Authorizing Official
Poudre Valley Hospital
Stephanie Doughty, Chief Financial Officer
(970) 237-7003
Primary Contact
Poudre Valley Hospital
Rodney Good, Sr Director Pharmacy Services
(970) 213-9246
Addresses
Street Address
1455 Main St
Suite 130
Windsor, CO 80550-5559
Billing Address
Poudre Valley Health Care Inc
2315 E Harmony Road
Suite 200
Fort Collins, CO 80528-8620
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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