340B Drug Pricing Program Database
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PED063301-95 Children's Hospital Colorado (Active)
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Main Details
Name
Children's Hospital Colorado
Subdivision Name
Children's Hospital Colorado - North Campus Eye Clinic
Type
Children's Hospital
Rural
No
340B ID
PED063301-95
Medicare Provider Number
063301
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/13/2021
Participating Start Date
1/1/2022
Participating Approval Date
11/1/2021
Last Recertification Date
9/4/2024
Contacts
Authorizing Official
Children's Hospital Colorado
Casey Dugan, Vice President of Pharmacy Services
(720) 777-5683
Primary Contact
Children's Hospital Colorado
Ricardo Alexis Laremont, Pharmacy 340B Program Manager
(720) 777-8899
Addresses
Street Address
469 State Highway 7
Broomfield, CO 80023
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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