340B Drug Pricing Program Database
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DSH060010S POUDRE VALLEY HOSPITAL (Active)
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Main Details
Name
POUDRE VALLEY HOSPITAL
Subdivision Name
PVH Sleep Lab - Sleep Lab
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH060010S
Medicare Provider Number
060010
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/13/2023
Participating Start Date
7/1/2023
Participating Approval Date
5/17/2023
Last Recertification Date
8/14/2024
Contacts
Authorizing Official
Poudre Valley Health Care, Inc.
David Charles Thompson, Chief Financial Officer
(970) 237-7011
Primary Contact
Poudre Valley Health Care, Inc.
Andrew Harmon, Director of Pharmacy
(970) 495-8054
Addresses
Street Address
1107 S. Lemay Avenue
260
Fort Collins, CO 80524
Billing Address
Poudre Valley Health Care, Inc. d/b/a Poudre Valley Hospital
2315 E. Harmony Road
200
Fort Collins, CO 80528
Comments
Medicaid Billing
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