340B Drug Pricing Program Database
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DSH320002V ST. VINCENT HOSPITAL (Terminated)
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Main Details
Name
ST. VINCENT HOSPITAL
Subdivision Name
ST VINCENT Entrada Contenta Emergency Services - Free Standing Emergency Department
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH320002V
Medicare Provider Number
320002
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/14/2020
Participating Start Date
4/1/2020
Participating Approval Date
2/11/2020
Last Recertification Date
8/26/2020
Termination Date
Termination Reason
10/1/2021
Business decision by the Covered Entity
Contacts
Authorizing Official
St. Vincent Hospital
Lillian Montoya, President and CEO
(505) 913-5258
Primary Contact
St. Vincent Hospital
Christine Atwell, Director of Pharmacy
(505) 913-5522
Addresses
Street Address
5501 Herrera Drive
Santa Fe, NM 87507-2684
Billing Address
ST VINCENT HOSPITAL
455 SAINT MICHAEL DRIVE
SANTA FE, NM 87507-7601
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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