340B Drug Pricing Program Database
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DSH060103F AdventHealth Avista (Active)
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Main Details
Name
AdventHealth Avista
Subdivision Name
AdventHealth Hematology and Oncology at Parker
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH060103F
Medicare Provider Number
060103
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/11/2018
Participating Start Date
7/1/2018
Participating Approval Date
4/20/2018
Last Recertification Date
9/3/2024
Contacts
Authorizing Official
AdventHealth
Jonathan Erickson, Avista CFO
(303) 673-1000
Primary Contact
AdventHealth
Dustin Lott Jones, 340B Coordinator
(254) 833-1495
Addresses
Street Address
9403 Crown Crest Blvd.
Suite 115
Parker, CO 80138
Billing Address
AdventHealth Avista
c/o AdventHealth
902 Inspiration Avenue
Suite 9100
Altamonte Springs, FL 32714
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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