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CAH061317-01 Grand River Hospital District (Active)
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Main Details
Name
Grand River Hospital District
Subdivision Name
Grand River Health Clinic West
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH061317-01
Medicare Provider Number
061317
Outpatient Facility Provider Number
063996
Additional Details
Current Program Status
Active
Registration Date
4/12/2018
Participating Start Date
7/1/2018
Participating Approval Date
6/6/2018
Last Recertification Date
8/23/2024
Contacts
Authorizing Official
Grand River Health
Terry Collins, CFO
(970) 625-6462
Primary Contact
Grand River Hospital District
Shane Becker, 340B Program Coordinator
(970) 625-6424
Addresses
Street Address
201 SIPPRELLE DR
PARACHUTE, CO 81635-9234
Billing Address
Grand River Hospital District
501 Airport Rd
Rifle, CO 81650
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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