340B Drug Pricing Program Database
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DSH320021EN PRESBYTERIAN HOSPITAL (Active)
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Main Details
Name
PRESBYTERIAN HOSPITAL
Subdivision Name
COMPLETE CARE CLINIC
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH320021EN
Medicare Provider Number
320021
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/11/2019
Participating Start Date
10/1/2019
Participating Approval Date
8/2/2019
Last Recertification Date
9/6/2024
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
8100 Constitution Place
Ste 310
ALBUQUERQUE, NM 87110
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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