340B Drug Pricing Program Database
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DSH320021FB PRESBYTERIAN HOSPITAL (Active)
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Main Details
Name
PRESBYTERIAN HOSPITAL
Subdivision Name
PMG Northside Pediatric Urgent Care
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH320021FB
Medicare Provider Number
320021
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/14/2022
Participating Start Date
10/1/2022
Participating Approval Date
7/28/2022
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
5901 Harper Dr. NE
Albuquerque, NM 87109
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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