340B Drug Pricing Program Database
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DSH060013 Mercy Hospital (Active)
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Main Details
Name
Mercy Hospital
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH060013
Medicare Provider Number
060013
Additional Details
Current Program Status
Active
Registration Date
10/9/2019
Participating Start Date
1/1/2020
Participating Approval Date
10/21/2019
Last Recertification Date
9/10/2024
Contacts
Authorizing Official
CommonSpirit Health
Justin Bollenback, CFO and VP of Finance
(970) 247-4311
Primary Contact
CommonSpirit Health
Samantha Morgan, System Manager, 340B Program
(303) 673-7354
Addresses
Street Address
1010 THREE SPRINGS BLVD.
DURANGO, CO 81301
Billing Address
CommonSpirit Health
PO Box 372660
Denver, CO 80237
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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