340B Drug Pricing Program Database
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DSH060031AB Penrose Hospital (Active)
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Main Details
Name
Penrose Hospital
Subdivision Name
Penrose Cardiology - Cardiology
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH060031AB
Medicare Provider Number
060031
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/10/2022
Participating Start Date
1/1/2023
Participating Approval Date
10/20/2022
Last Recertification Date
9/4/2024
Contacts
Authorizing Official
Penrose St. Francis Health Services
Kevin Wikoff, Market CFO
(719) 571-2498
Primary Contact
CommonSpirit Health
Samantha Morgan, System Manager, 340B Mountain Region
(303) 673-7380
Addresses
Street Address
2222 N NEVADA AVE
4007
COLORADO SPRINGS, CO 80907
Billing Address
CommonSpirit Health
PO BOX 372660
Denver, CO 80237
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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