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DSH320002S ST. VINCENT HOSPITAL (Active)
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Main Details
Name
ST. VINCENT HOSPITAL
Subdivision Name
CHRISTUS ST VINCENT MEDICATION MANAGEMENT SERVICES CLINIC
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH320002S
Medicare Provider Number
320002
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/7/2017
Participating Start Date
10/1/2017
Participating Approval Date
7/13/2017
Last Recertification Date
8/23/2024
Contacts
Authorizing Official
St. Vincent Hospital
Lillian Montoya, President and CEO
(505) 913-5258
Primary Contact
St. Vincent Hospital
Christine Atwell, Director of Pharmacy
(505) 913-5522
Addresses
Street Address
465 ST MICHAELS DRIVE SUITE 114
CHRISTUS ST VINCENT MEDICATION MANAGEMENT SERVICES CLINIC
SANTA FE, NM 87505-7621
Billing Address
St. Vincent Hospital
455 St. Michaels Drive
Santa Fe, NM 87505
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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