340B Drug Pricing Program Database
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DSH320021ED PRESBYTERIAN HOSPITAL (Terminated)
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Main Details
Name
PRESBYTERIAN HOSPITAL
Subdivision Name
Presbyterian Medical Group High Resort Pediatric Urgent Care
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH320021ED
Medicare Provider Number
320021
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/3/2018
Participating Start Date
10/1/2018
Participating Approval Date
7/27/2018
Last Recertification Date
9/8/2023
Termination Date
Termination Reason
10/1/2024
Site closure
Contacts
Authorizing Official
Presbyterian Healthcare Services
Erica Downing, VP, Pharmacy and Infusion Services & Chief Pharmacy Officer
(505) 724-8994
Primary Contact
Presbyterian Healthcare Services
Barbara Fried-Smith, 340B Program Coordinator
(505) 886-4820
Addresses
Street Address
4100 High Resort Boulevard
Rio Rancho, NM 87124
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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