340B Drug Pricing Program Database
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DSH460009JR University of Utah (Active)
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Main Details
Name
University of Utah
Subdivision Name
UNIVERSITY OF UTAH HOSPITALS AND CL - HCH BREAST CARE CLINIC
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH460009JR
Medicare Provider Number
460009
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/6/2023
Participating Start Date
1/1/2024
Participating Approval Date
11/27/2023
Last Recertification Date
8/21/2024
Contacts
Authorizing Official
University of Utah Hospitals and Clinics
Charlton Gordon Park, Chief Financial Officer
(801) 585-1325
Primary Contact
University of Utah Health
Sara Bamford, 340B Pharmacy Manager
(801) 587-1229
Addresses
Street Address
1950 CIRCLE OF HOPE DR
SALT LAKE CITY, UT 84112-5500
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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