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DSH060031Z PENROSE/ST. FRANCIS HEALTHCARE (Terminated)
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Main Details
Name
PENROSE/ST. FRANCIS HEALTHCARE
Subdivision Name
St. Francis Medical Center - Special Procedures - SFMC Special Procedures
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH060031Z
Medicare Provider Number
060031
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/8/2019
Participating Start Date
1/1/2020
Participating Approval Date
10/15/2019
Last Recertification Date
Termination Date
Termination Reason
10/1/2020
Other
Contacts
Authorizing Official
Centura-Penrose St. Francis
Patrick T Ballard, Chief Financial Officer, Penrose-St. Francis Health Services
(719) 776-5911
Primary Contact
Centura-Penrose St. Francis
Alison Schlang, Director of Pharmacy, Penrose-St. Francis Health Services
(719) 776-4489
Addresses
Street Address
6001 E Woodmen Rd
Colorado Springs, CO 80923-2691
Billing Address
Centura Health/AP Dept
PO Box 372660
Denver, CO 80237
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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